Contemporary Soft Tissue Management of Peri-Implantitis: Current Concepts for Long-Term Implant Care

Peri-implantitis is a biofilm-associated inflammatory disease characterized by progressive loss of supporting bone and late implant failure.Soft-tissue dimensions and prosthetic cleansability are relevant to tissue stability and maintainability, but increasing keratinized mucosal width or thickness has not been consistently shown to independently reduce the recurrence of peri-implantitis.This narrative review discusses peri-implant soft tissue biology, augmentation, prosthetic contours, and maintenance.Literature was selected purposively, with targeted supplementary literature checks.The selection was not exhaustive; the original search log was incomplete, and the certainty of the evidence was not formally assessed.Much of the augmentation evidence concerns healthy or newly placed implants rather than implants with established peri-implantitis.Connective tissue grafts, free gingival grafts, and collagen matrices address different tissue deficiencies.Selection depends on implant position, tissue support, patient preferences, and hygiene access.Augmentation is an adjunct to disease control, implant-surface and osseous-defect management, prosthetic correction, and supportive care.Improved tissue dimensions should not be interpreted as evidence of improved peri-implantitis resolution or implant survival; the independent long-term benefit of augmentation remains uncertain.