Early soft tissue healing around one-stage dental implants: clinical and microbiologic parameters

BACKGROUND: Despite the potential significance of early soft tissue healing to long-term outcomes, this aspect of one-stage dental implants has not been investigated. The purpose of this prospective study was to characterize clinical and microbiologic parameters of early soft tissue healing around dental implants placed following a one-stage protocol. METHODS: Twenty-one patients (11 females and 10 males, aged 18 to 78 years; two smokers) needing a single implant were included. Clinical parameters included probing depth, buccal flap thickness, papilla height, and bleeding on probing. Subgingival plaque samples were obtained pre- and postoperatively and analyzed using molecular techniques. RESULTS: The newly formed peri-implant sulcus probing depth remained fairly stable from 4 to 12 weeks (P > 0.05). There was no statistically significant association between flap thickness or papillary height and number of implant bleeding sites at 12 weeks (P > 0.05). Detection of known periodontal pathogens was rare. Fusobacterium nucleatum was present in 17 patients prior to surgery, and 71% of them became carriers of this bacterium at the implant site by the second postoperative week. The number of F. nucleatum-positive subjects around the implant was significantly lower than the number of F. nucleatum-positive subjects around teeth (P < 0.05). CONCLUSIONS: Peri-implant soft tissue clinical maturity may be established as early as 4 weeks following implant placement by a one-stage surgical protocol; neither preexisting flap thickness nor papillary height seemed to influence newly forming peri-implant sulcus depth or bleeding on probing prevalence. For the most part, the newly created peri-implant crevices were colonized by specific bacteria within 2 weeks.