The Role of Keratinized Tissue in Dental Implants and Healthy Teeth

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When you look at your teeth in the mirror, you're likely to see a band of tissue surrounding the teeth at the spot where they meet your gums. That band of tissue at the base of the tooth is known as keratinized tissue or keratinized mucosa, explains the University of Pittsburgh School of Dental Medicine. When all is well with your mouth, the tissue will be securely attached to your teeth, feel firm to the touch and range from pink to brown in color, depending on your skin tone.

The keratinized tissue doesn't only hold your natural teeth in place. The tissue helps protect the roots of the teeth and plays an important role when it comes to the appearance of your smile, since the gums cover up the roots and keep the teeth from looking too long.

If you need dental implants, the tissue also provides support to the replacement teeth and may help improve the success of the implants. Depending on the amount of keratinized tissue you naturally have around your teeth, your dentist might consider adding more tissue when placing an implant.

How Do Dental Implants Work?

A dental implant is a type of replacement tooth. The American Academy of Implant Dentistry describes implants as artificial tooth roots. The implant itself consists of a post that is positioned in the jawbone. A small connector, called an abutment, sticks out from the bone and a crown is placed on top of it. Dental implants are meant to be permanent replacements for missing teeth. Unlike other tooth replacement options, such as dentures or bridges, implants are fixed in the mouth and can't be removed.

Dental Implants and Keratinized Tissue

The amount of keratinized tissue a patient has around a dental implant may play a critical role when it comes to the appearance of the implant, the placement of the implant and the patient's ability to keep the implant clean. A study published in The Journal of Indian Prosthodontic Society found that it was important to assess the width and thickness of the tissue prior to dental implant placement. The study concluded that having an adequate amount of keratinized gum tissue was critical for long-term implant success.

If they feel it's necessary, dentists can increase the amount of tissue at the site of the implant. A study published in the Journal of Cosmetic Dentistry found that preserving or reconstructing the band of gum tissue at the site of an implant may improve the appearance of the prosthetic tooth, as well as aid in controlling plaque buildup around the implant.

Dentists often disagree on the precise amount of tissue required for a dental implant, as noted by both studies, but it's clear that the presence of keratinized tissue is necessary for effective implant placement.

Dental Procedures to Add Tissue

If a dental implant patient doesn't have an adequate amount of gum tissue in the implant area, dentists have multiple options to provide additional tissue. Dentists may perform a modified apically repositioned flap technique, where a part of the gum is cut and reattached. This procedure triggers the healing process and encourages the production of additional tissue, explains a case report in the Journal of Dental & Orofacial Research. Alternatively, a dentist may transplant tissue from another part of the mouth, such as the palate, through a procedure known as a gum graft, according to the study published in the Journal of Cosmetic Dentistry.

As the study in the Journal of Cosmetic Dentistry notes, a dentist can manage an implant patient's tissue at three separate points: before the implant is placed, during placement or afterward. Increasing the amount of tissue before the implant is placed may help the implants last for as long as possible.

Caring for Your Dental Implants

Ensuring that there's adequate tissue around dental implants is just one way to improve the chances of their success. Once you have a dental implant, take care of it just like you would a natural tooth. Brush all of your teeth with fluoride toothpaste at least twice a day and floss daily, paying special attention to the areas around your implant. Seeing your dentist for regular cleanings and exams is also critical. Your dentist can keep an eye on the dental implant and let you know if any issues arise. Together, you can discuss how to make sure your dental implants look and feel great for many years to come.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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What Are The Different Parts Of A Tooth?

Each tooth has several distinct parts; here is an overview of each part:

  • Enamel – this is the outer and hardest part of the tooth that has the most mineralized tissue in the body. It can be damaged by decay if teeth are not cared for properly.

  • Dentin – this is the layer of the tooth under the enamel. If decay makes it through the enamel, it next attacks the dentin — where millions of tiny tubes lead directly to the dental pulp.

  • Pulp – this is the soft tissue found in the center of all teeth, where the nerve tissue and blood vessels are located. If tooth decay reaches the pulp, you usually feel pain and may require a root canal procedure.