Evidence map›Paper›PMID 40689718›Full record

ArticleJournal of periodontal research2025

Role of Keratinized Mucosa on the Risk of Peri-Implant Diseases and Soft Tissue Dehiscence in the Posterior Mandible-A 20-Year Prospective Cohort Study.

Andrea Roccuzzo, Jean-Claude Imber, Alexandra Stähli, Mario Romandini, Anton Sculean, Giovanni E Salvi, Mario Roccuzzo

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In one paragraph

Article in Journal of periodontal research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Observational
  8. Article
  9. Review
  10. Article
  11. Bone Grafts: Everything You Need to Know.Journal of periodontal research · 2026
    Review
  12. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Andrea RoccuzzoShanghai Perio-Implant Innovation Center, Institute of Integrated Oral, Craniofacial and Sensory Research, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0002-8079-0860
Jean-Claude ImberDepartment of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0001-6690-5249
Alexandra StähliDepartment of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Mario RomandiniShanghai Perio-Implant Innovation Center, Institute of Integrated Oral, Craniofacial and Sensory Research, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0001-5646-083X
Anton SculeanDepartment of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0003-2836-5477
Giovanni E SalviDepartment of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Mario RoccuzzoDivision of Maxillofacial Surgery, University of Torino, Torino, Italy.ORCID https://orcid.org/0000-0002-2135-6503

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo evaluate the 20-year outcomes of tissue-level implants placed in the posterior mandible, comparing implants surrounded by keratinized tissue (KT) or alveolar mucosa (AM).

methodsAt baseline, 128 patients (128 implants) were rehabilitated with implant-supported fixed dental prostheses in the posterior mandible and enrolled in a supportive periodontal/peri-implant care (SPC) program. Patients were categorized based on the presence (KT) or absence (AM) of keratinized mucosa. During the first 10 years of SPC, 11 AM patients underwent free gingival grafting (FGG), identifying a third group (AM + FGG). At the 20-year follow-up, peri-implant health status and soft-tissue dehiscence were assessed according to the 2018 Case Definitions. The need for additional treatment between the 10- and 20-year examinations was also recorded.

resultsOf the 98 patients evaluated at the 10-year follow-up, 64 (KT = 42; AM = 16; AM + FGG = 6; drop-out rate: 35%) attended the 20-year examination. Additional treatment was required in 11 AM patients (50%) versus 2 KT patients (5%) (p < 0.01). AM implants exhibited significantly greater marginal bone loss, bleeding on probing, and soft tissue recession compared to KT implants (p < 0.01). The application of an FGG (AM + FGG = 6) had a protective effect on peri-implant health status at 20 years. Peri-implantitis was diagnosed in 4.2% of implants surrounded by keratinized mucosa (KT or AM + FGG) versus 25% in the AM group (OR = 6.67; 95% CI: 1.09-40.9; p = 0.041).

conclusionTissue level implants placed in the posterior mandible without KT showed greater marginal bone loss, bleeding on probing, soft tissue recession, and peri-implant diseases compared to implants with KT at 20 years.

Indexed as

Dental Implantation, EndosseousDental ImplantsGingivaMandibleMouth MucosaPeri-ImplantitisSurgical Wound DehiscenceAdultAgedDental Prosthesis, Implant-SupportedFemaleHumansKeratinsMaleMiddle AgedProspective StudiesDental ImplantsKeratinsclinical trialdental implantsfree gingival graftlong‐termsoft tissue graft

Identifiers

PMID40689718
PMCPMC12881885

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.