Impact of peri‐implant keratinized mucosa width on the long‐term reconstructive outcomes of peri‐implantitis: A retrospective analysis with a follow‐up up to 10 years

Purpose To investigate the effect of mid‐buccal peri‐implant keratinized mucosa width (KMW) ≥2 mm or peri‐implant KMW >0 mm and <2 mm on the long‐term outcomes of peri‐implantitis reconstructive treatment. Materials and Methods Twenty‐nine patients (40 implants; mean follow‐up: 9.2 ± 1.4 years) with at least one implant affected by peri‐implantitis and surgically treated through a reconstructive procedure followed by a submerged healing were included. Patients were categorized according to their initial KMW: Group 1 (KMW ≥2 mm) and Group 2 (KMW >0 mm and <2 mm). Peri‐implant clinical and radiographic parameters and a dedicated composite outcome were assessed at different follow‐up visits during supportive peri‐implant therapy for up to 10 years. Regression analyses were utilized to identify possible risk/predictive indicators for probing pocket depth (PPD) change and treatment success at the latest follow‐up. Results The mean PPD did not exhibit any statistical difference from the baseline to the latest follow‐up between the groups at both patient and implant levels. Long‐term treatment success was 46.6% (Group 1) and 42.6% (Group 2) at patient level, it was 42.8% (Group 1) and 33.3% (Group 2), respectively, at implant level ( p > 0.05). Group 1 demonstrated significantly higher vertical defect depth reduction than Group 2 ( p = 0.018). Presence of buccal bony wall and mean PPD at the baseline were found to be associated with mean PPD change, while KMW at 6 months following surgery was identified as the only significant indicator for treatment success ( p < 0.05). Conclusion Implants with KMW ≥2 mm did not present significantly better long‐term clinical outcomes following reconstructive therapy than those exhibiting KMW >0 mm and <2 mm. However, KMW values at the end of healing phase following a submerged approach had a significant impact on long‐term treatment success.