Review

. 2025 Jun 19;17(1):51.

doi: 10.1038/s41368-025-00379-3.

Expert consensus on peri-implant keratinized mucosa augmentation at second-stage surgery

Shiwen Zhang^#¹, Rui Sheng^#¹, Zhen Fan^#², Fang Wang², Ping Di³, Junyu Shi⁴, Duohong Zou⁵, Dehua Li⁶, Yufeng Zhang⁷, Zhuofan Chen⁸, Guoli Yang⁹, Wei Geng¹⁰, Lin Wang¹¹, Jian Zhang¹², Yuanding Huang¹³, Baohong Zhao¹⁴, Chunbo Tang¹⁵, Dong Wu¹⁶, Shulan Xu¹⁷, Cheng Yang¹⁸, Yongbin Mou¹⁹, Jiacai He²⁰, Xingmei Yang¹, Zhen Tan¹, Xiaoxiao Cai¹, Jiang Chen¹⁶, Hongchang Lai⁴, Zuolin Wang²¹, Quan Yuan²²

Affiliations

¹ State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.
² Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology & Department of implantology, Shanghai Tongji Stomatological Hospital and Dental School, Tongji University, Shanghai, China.
³ Department of Implantology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Peking University School and Hospital of Stomatology, Beijing, China.
⁴ Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵ Department of Oral Surgery, Shanghai Ninth People's Hospital College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁶ State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, China.
⁷ Department of Oral Implantology, University of Wuhan, Wuhan, China.
⁸ Hospital of Stomatology, Guanghua School of Stomatology and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
⁹ Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
¹⁰ Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China.
¹¹ Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China.
¹² Department of Oral Implantology, Tianjin Stomatological Hospital, School of Medicine, Nankai University & Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China.
¹³ Department of implantology, Stomatological Hospital of Chongqing Medical University, Chongqing, China.
¹⁴ Department of Oral Implantology, School and Hospital of Stomatology, Key Laboratory of Oral Diseases of Liaoning province, China Medical University, Shenyang, China.
¹⁵ Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China.
¹⁶ Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
¹⁷ Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China.
¹⁸ Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China.
¹⁹ Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
²⁰ College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, China.
²¹ Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology & Department of implantology, Shanghai Tongji Stomatological Hospital and Dental School, Tongji University, Shanghai, China. zuolin@tongji.edu.cn.
²² State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China. yuanquan@scu.edu.cn.

^# Contributed equally.

PMID: 40537484
PMCID: PMC12179315
DOI: 10.1038/s41368-025-00379-3

Review

Expert consensus on peri-implant keratinized mucosa augmentation at second-stage surgery

Shiwen Zhang et al. Int J Oral Sci. 2025.

. 2025 Jun 19;17(1):51.

doi: 10.1038/s41368-025-00379-3.

Authors

Affiliations

¹ State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.
² Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology & Department of implantology, Shanghai Tongji Stomatological Hospital and Dental School, Tongji University, Shanghai, China.
³ Department of Implantology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Peking University School and Hospital of Stomatology, Beijing, China.
⁴ Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵ Department of Oral Surgery, Shanghai Ninth People's Hospital College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁶ State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, China.
⁷ Department of Oral Implantology, University of Wuhan, Wuhan, China.
⁸ Hospital of Stomatology, Guanghua School of Stomatology and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
⁹ Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
¹⁰ Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China.
¹¹ Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China.
¹² Department of Oral Implantology, Tianjin Stomatological Hospital, School of Medicine, Nankai University & Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China.
¹³ Department of implantology, Stomatological Hospital of Chongqing Medical University, Chongqing, China.
¹⁴ Department of Oral Implantology, School and Hospital of Stomatology, Key Laboratory of Oral Diseases of Liaoning province, China Medical University, Shenyang, China.
¹⁵ Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China.
¹⁶ Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
¹⁷ Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China.
¹⁸ Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China.
¹⁹ Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
²⁰ College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, China.
²¹ Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology & Department of implantology, Shanghai Tongji Stomatological Hospital and Dental School, Tongji University, Shanghai, China. zuolin@tongji.edu.cn.
²² State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China. yuanquan@scu.edu.cn.

^# Contributed equally.

PMID: 40537484
PMCID: PMC12179315
DOI: 10.1038/s41368-025-00379-3

Abstract

Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.

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Conflict of interest statement

Competing interests: The authors declare no competing interests.

Figures

**Fig. 1**
Decision tree of PIKM augmentation at second-stage surgery

See this image and copyright information in PMC

References

1. Wang, Y., Zhang, Y. & Miron, R. Health, maintenance, and recovery of soft tissues around implants. Clin. Implant Dent. Relat. Res.18, 618–634 (2016). - DOI - PubMed
1. Stefanini, M. et al. Do soft tissue augmentation techniques provide stable and favorable peri-implant conditions in the medium and long term? A systematic review. Clin. Oral. Implants Res.34, 28–42 (2023). - DOI - PubMed
1. Roccuzzo, M. & Sculean, A. Peri-Implant Soft-Tissue Integration and Management. Vol. 12 (Quintessenz Verlag, 2021).
1. Ivanovski, S. & Lee, R. Comparison of peri-implant and periodontal marginal soft tissues in health and disease. Periodontology 200076, 116 (2018). - DOI - PubMed
1. Tavelli, L. et al. Peri-implant soft tissue phenotype modification and its impact on peri-implant health: a systematic review and network meta-analysis. J. Periodontol.92, 21–44 (2020). - PubMed

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Expert consensus on peri-implant keratinized mucosa augmentation at second-stage surgery

Affiliations

Expert consensus on peri-implant keratinized mucosa augmentation at second-stage surgery

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources