Coverage of mucosal recessions at dental implants.

Facial peri-implant mucosal recessions represent an increasing complication in implant dentistry and may negatively affect the esthetic outcome and patient satisfaction. The aim of the present paper is to provide a review on the potential causes of facial peri-implant mucosal recessions and to provide a rationale for treatment along with possible treatment options. The available data indicate that soft tissue augmentation around dental implants is possible, but at present there is no evidence demonstrating that the augmented soft tissues are able to influence the peri-implant bone levels (e.g. to limit peri-implant bone loss). Therefore, the rationale to cover or correct peri-implant mucosal recessions are (i) to optimize the possibility for performing an adequate level of oral hygiene, and (ii) to improve esthetics. At present, there is very limited evidence supporting any specific treatment modality for covering peri-implant soft tissue recessions. The limited available data indicate that only shallow peri-implant mucosal recessions (e.g. up to 2 mm) may be treated successfully by means of a coronally advanced flap and subepithelial connective tissue graft or with guided bone regeneration, while no data are available supporting the possibility of covering deep and large peri-implant mucosal recessions.