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Quintessence International



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Quintessence Int 36 (2005), No. 10     7. Oct. 2005
Quintessence Int 36 (2005), No. 10  (07.10.2005)

Page 759-769

Principles and mechanisms of peri-implant soft tissue healing
Schultze-Mosgau, Stefan/Blatz, Markus B./Wehrhan, Falk/Schlegel, Karl Andreas/Thorwart, Michael/Holst, Stefan
The long-term clinical and esthetic success of implant-supported restorations is determined by osseointegration and optimal remodeling of peri-implant soft tissues. Complications of soft-tissue management are often caused by fibrotic regeneration of oral mucosa after multiple surgical procedures. Knowledge of the proliferative processes in wound healing is necessary to attain adequate soft-tissue conditions. Successful reconstruction of peri-implant soft tissues is feasible even in fibrotic conditions when appropriate surgical techniques are selected. The pleiotropic proliferative cytokine TGF-b is involved in the regulation of all phases of wound healing and tissue remodeling. The isoform TGF-b1 is a cytokine associated with the development of fibrotic tissue. Overexpression of TGF-b1 causes scarring and fibrosis, and results in limited clinical success of intraoral soft-tissue management. Experimental therapeutic approaches with neutralizing antibodies to block TGF-b1 resulted in less scarring and a reduction of fibrosis. Further molecular biologic research of cell-matrix-cytokine interactions in wound healing will provide highly specific antifibrotic therapeutic approaches in the future.

Keywords: fibrosis, implants, soft tissue, transforming growth factor-beta, wound healing