Objective: To examine whether or not there is an association between the width of keratinized mucosa and the health of implant supporting tissues. Methods: Data on 200 dental implants was collected. Periodontal parameters measured included plaque index (PI), gingival index (GI), width of keratinized gingiva (WKG), thickness of keratinized gingiva (TKG), radiographic bone loss (RBL), and bleeding on probing (BOP). Statistical analysis was accomplished with t-test, Wilcoxon rank sum test, and logistic regression models. Results: The means GI, PI, and RBL were significantly higher for those implants with a narrow zone of keratinized mucosa. Implants with a narrow zone of keratinized tissue also were more likely to have bleeding upon probing even after adjusting for plaque index, smoking, and time since implant placement (adjusted OR, 2.37; 95% CI, 1.04-5.83). Conclusions: The increased width of keratinized tissue around implants is associated with better health of implant-mucosa interface. In presence of a narrow zone of keratinized tissue, the implant transmucosal attachment may be less resistant to bacterial insult, resulting in a rapid spread of inflammation.

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