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. 2025 Jan 11;25(1):61.
doi: 10.1186/s12903-025-05426-3.

Influence of buccal mucosa width/height ratio, emergence profile and buccal bone width on peri-implant tissues: a prospective one-year study

Yiman Tang #  1 , Juan Wang #  1 , Lixin Qiu  1 , Huajie Yu  2
Affiliations

Influence of buccal mucosa width/height ratio, emergence profile and buccal bone width on peri-implant tissues: a prospective one-year study

Yiman Tang et al. BMC Oral Health. .

Abstract

Background: The stability of soft and hard tissues surrounding the implant is not only a matter of aesthetics, but also affects the long-term stability of the implant. The present study was to explore the influence of buccal mucosa width/height (W/H) ratio, emergence profile and buccal bone width on peri-implant soft and hard tissue changes in the posterior region.

Methods: Fifty-eight posterior implant restoration cases were recruited in this study. Evaluations were performed at the time of restoration placement (T0), and 1 year later (T1). Buccal mucosa width (BMW), buccal bone width (BBW), implant buccal inclination angle, and emergence angle were evaluated. The variables that may affect buccal mucosa recession (MR) as well as vertical bone loss (VBL) were analyzed.

Results: The BMW at baseline was 2.93 ± 1.01 mm. The BBW at baseline was 1.50 ± 0.82 mm. The buccal mucosa W/H ratio at 1 year (1.23 ± 0.38) was significantly lower than that at baseline (1.42 ± 0.45). Buccal MR was - 0.22 ± 0.47 mm while VBL was 0.81 ± 0.80 mm. The correlation between MR and initial BMW (r=-0.381), initial W/H ratio (r=-0.422), BBW (r=-0.290) was statistically significant. The correlation between VBL and initial BMW (r=-0.421), initial W/H ratio (r=-0.305), implant buccal inclination angle (r = 0.507), BBW (r=-0.556) was statistically significant.

Conclusions: Within the scope of this study, implant sites in the posterior region presenting a thin BMW, a thin BBW, and a small W/H ratio are more prone to exhibit buccal mucosa recession and vertical bone loss.

Keywords: Buccal mucosa width; Mucosa recession; Vertical bone loss; W/H ratio.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Peking University Hospital of Stomatology (approval number PKUSSIRB-201840189). This trial was registered on the Chinese Clinical Trial Registry ( http://www.chictr.org.cn ) at 25th March, 2019, the number is ChiCTR1900022101. Written informed consent was obtained from individual or guardian participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Representative clinical case. a Preoperative intraoral photograph. b Measurement of the buccal bone width. c The implants were placed with 0.5 mm of the machined neck below the alveolar crest level. d Intraoral photograph after 3 months of implant healing. e The occlusal view of implant-supported zirconia crown. f The buccal view of implant-supported zirconia crown. g radiographic photograph after crown loading
Fig. 2
Fig. 2
Digital model superimposition and management. a The central axis (Line O) was established by the “best-fit alignment” to the implant analog. Plane O was defined by the midpoints of two central incisors and the proximal mesiobuccal cusps of the two first molars. Plane B was defined by the plane across the midpoints of mesial and distal contact area of the implant crown and perpendicular to the occlusal plane. b The implant buccal inclination angle (IBA) was defined by the angle between the implant long axis and the buccal reference plane
Fig. 3
Fig. 3
The schematic diagram for the analysis of soft and hard tissue alterations. a Measurement of the buccal mucosa width (W) and height (H). b Measurement of buccal bone width (BBW). c Measurement of emergence angle (EA). Line O: the implant long axis. Line A: the tangent line of the restoration at the most coronal point of the buccal mucosa
Fig. 4
Fig. 4
The scatter diagram showing the relationship between buccal mucosa recession and different variables. a The relationship between buccal mucosa recession and BMW. b The relationship between buccal mucosa recession and buccal mucosa W/H. c The relationship between buccal mucosa recession and BBW. Abbreviations: BMW, buccal mucosa width. BBW, buccal bone width. W/H, buccal mucosa width/height ratio
Fig. 5
Fig. 5
The scatter diagram showing the relationship between buccal vertical bone loss and different variables. a The relationship between buccal vertical bone loss and BMW. b The relationship between buccal vertical bone loss and buccal mucosa W/H. c The relationship between buccal vertical bone loss and BBW. d The relationship between buccal vertical bone loss and implant buccal inclination angle. Abbreviations: BMW, buccal mucosa width. BBW, buccal bone width. W/H, buccal mucosa width/height ratio
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