Non-Cochrane · prognostic · PM42131984
Keratinized Mucosa Width and Incidence of Peri-Implant Diseases: A Systematic Review With Meta-Analysis.
Dos Reis Isabella Neme Ribeiro, Thoma Daniel Stefan, da Silva Thaís Emília, et al. · Journal of periodontal research · 2026 · PubMed · doi:10.1111/jre.70123
Findings
Population Patients (18 years or older) with dental implants
17 findings
| Keratinized mucosa present (> 0 mm) | Keratinized mucosa absent (0 mm) | Incidence of peri-implantitis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Prospective cohorts | RR 0.64 [0.31, 1.31] GRADE not reported 4 studies · 675 participants |
| Keratinized mucosa present (> 0 mm) | Keratinized mucosa absent (0 mm) | Incidence of peri-implantitis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Retrospective cohorts | RR 0.46 [0.21, 1.03] GRADE not reported 2 studies · 535 participants |
| Keratinized mucosa present (> 0 mm) | Keratinized mucosa absent (0 mm) | Incidence of peri-implantitis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Overall | RR 0.62 [0.42, 0.91] -42 [-64, -10] per 1000 (fewer if negative) Very low Downgraded: imprecision 6 studies · 1210 participants |
| Keratinized mucosa present (> 0 mm) | Keratinized mucosa absent (0 mm) | Incidence of peri-implant mucositis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Follow-up duration (<= 5 years vs > 5 years) Unresolved: the two extractors disagree on this row. | No significant associations in either follow-up subgroup; larger protective estimates with > 5 years, not significant GRADE not reported Studies not reported |
| Keratinized mucosa present (> 0 mm) | Keratinized mucosa absent (0 mm) | Incidence of peri-implant mucositis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Prospective cohorts | RR 0.91 [0.60, 1.39] GRADE not reported 4 studies · 675 participants |
| Keratinized mucosa present (> 0 mm) | Keratinized mucosa absent (0 mm) | Incidence of peri-implant mucositis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Overall | RR 0.92 [0.69, 1.21] -33 [-127, 86] per 1000 (fewer if negative) Very low Downgraded: imprecision, inconsistency 5 studies · 1096 participants |
| Keratinized mucosa present (> 0 mm) | Keratinized mucosa absent (0 mm) | Incidence of peri-implantitis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Follow-up duration (<= 5 years vs > 5 years) Unresolved: the two extractors disagree on this row. | Protective pattern in both follow-up periods, tending to be larger with longer follow-up; difference not significant GRADE not reported Studies not reported |
| Keratinized mucosa present (> 0 mm) | Keratinized mucosa absent (0 mm) | Incidence of peri-implantitis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Peri-implantitis case definition thresholds (marginal bone loss and probing depth) Unresolved: the two extractors disagree on this row. | Direction consistent across definitions; no significant subgroup difference (p = 0.55) GRADE not reported Studies not reported |
| Keratinized mucosa width >= 2 mm | Keratinized mucosa width < 2 mm | Incidence of peri-implantitis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Overall | RR 0.56 [0.37, 0.84] -61 [-87, -22] per 1000 (fewer if negative) Low Downgraded: inconsistency 9 studies · 2453 participants |
| Keratinized mucosa width >= 2 mm | Keratinized mucosa width < 2 mm | Incidence of peri-implantitis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Follow-up duration (<= 5 years vs > 5 years) Unresolved: the two extractors disagree on this row. | Protective pattern in both follow-up periods, tending to be larger with longer follow-up; difference not significant GRADE not reported Studies not reported |
| Keratinized mucosa width >= 2 mm | Keratinized mucosa width < 2 mm | Incidence of peri-implantitis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Prospective cohorts | RR 0.64 [0.34, 1.19] GRADE not reported 4 studies · 824 participants |
| Keratinized mucosa width >= 2 mm | Keratinized mucosa width < 2 mm | Incidence of peri-implant mucositis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Overall | RR 0.70 [0.41, 1.20] -108 [-213, 72] per 1000 (fewer if negative) Very low Downgraded: imprecision, inconsistency 7 studies · 1899 participants |
| Keratinized mucosa width >= 2 mm | Keratinized mucosa width < 2 mm | Incidence of peri-implant mucositis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Retrospective cohorts | RR 0.98 [0.74, 1.28] GRADE not reported 3 studies · 1075 participants |
| Keratinized mucosa width >= 2 mm | Keratinized mucosa width < 2 mm | Incidence of peri-implant mucositis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Prospective cohorts | RR 0.60 [0.27, 1.32] GRADE not reported 4 studies · 824 participants |
| Keratinized mucosa width >= 2 mm | Keratinized mucosa width < 2 mm | Incidence of peri-implantitis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Peri-implantitis case definition thresholds (marginal bone loss and probing depth) Unresolved: the two extractors disagree on this row. | More stringent thresholds gave larger protective estimates; subgroup difference not significant (p = 0.07) GRADE not reported Studies not reported |
| Keratinized mucosa width >= 2 mm | Keratinized mucosa width < 2 mm | Incidence of peri-implantitis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Retrospective cohorts | RR 0.49 [0.26, 0.94] GRADE not reported 5 studies · 1629 participants |
| Keratinized mucosa width >= 2 mm | Keratinized mucosa width < 2 mm | Incidence of peri-implant mucositis (implant level) Follow-up 1 to 20 years across studies · Mostly university clinics · Follow-up duration (<= 5 years vs > 5 years) Unresolved: the two extractors disagree on this row. | No significant associations in either follow-up subgroup; larger protective estimates with > 5 years, not significant GRADE not reported Studies not reported |
Included primary studies 12
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Alhakeem 2023 Risk indicators of long-term outcome of implant therapy in patients with a history of severe periodontitis or no history of periodontitis:… PMID:35090086 | 2023 | 1 other review | not stated | not extracted yet |
| Bozkurt 2023 Effects of Peri-implant Mucosal Characteristics on Clinical Peri-implant Parameters: A Retrospective Study DOI:10.4274/meandros.galenos.2021.09582 | 2023 | this review only | not stated | not extracted yet |
| Costa 2019 Cumulative smoking exposure and cessation associated with the recurrence of periodontitis in periodontal maintenance therapy: A 6-year… PMID:30801706 | 2019 | this review only | not stated | not extracted yet |
| Felice 2023 Influence of Keratinized Tissue on Short Dental Implants: A Parallel Cohort Retrospective Study on 217 Implants with a Mean Follow-up of… PMID:37279215 | 2023 | this review only | not stated | not extracted yet |
| Fernandes 2023 Clinical Assessment of Short (> 6 mm and ≤ 8.5 mm) Implants in Posterior Sites with an Average Follow-Up of 74 Months: A Retrospective… PMID:37847833 | 2023 | this review only | not stated | not extracted yet |
| Lv 2024 Investigation of peri-implant diseases prevalence and related risk indicators in patients with treated severe periodontitis over 4 years… PMID:38618128 | 2024 | this review only | not stated | not extracted yet |
| Mancini 2024 Impact of keratinized mucosa on implant-health related parameters: A 10-year prospective re-analysis study. PMID:38419210 | 2024 | this review only | not stated | not extracted yet |
| Nicoli 2024 Patient-, implant- and prosthetic-related factors on peri-implant mucositis and bone loss. PMID:38747827 | 2024 | this review only | not stated | not extracted yet |
| Poli 2016 Risk indicators related to peri-implant disease: an observational retrospective cohort study. PMID:27588216 | 2016 | this review only | not stated | not extracted yet |
| Roccuzzo 2025 Role of Keratinized Mucosa on the Risk of Peri-Implant Diseases and Soft Tissue Dehiscence in the Posterior Mandible-A 20-Year Prospective… PMID:40689718 | 2025 | this review only | not stated | not extracted yet |
| Romandini 2025 Incidence and Risk Factors of Peri-Implantitis Over Time-A Prospective Cohort Study. PMID:39803810 | 2025 | this review only | not stated | not extracted yet |
| Ruiz-Romero 2024 Peri-implantitis in patients without regular supportive therapy: Prevalence and risk indicators. PMID:38671152 | 2024 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Impact of Open Proximal Contacts on Peri-Implant Diseases: A Systematic Review and Meta-Analysis. (2026) | 1 | 0.05 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients (18 years or older) with dental implants | 938 patients with 2646 implants (12 cohort studies) |
| Intervention | Inadequate keratinized mucosa width (e.g., 2 mm or less, or absence of keratinized mucosa) | Keratinized mucosa present (> 0 mm) or width >= 2 mm |
| Comparison | Adequate width of keratinized mucosa | Keratinized mucosa absent (0 mm) or width < 2 mm |
| Outcomes | Incidence of peri-implant diseases (peri-implant mucositis and/or peri-implantitis) at implant level | Peri-implant mucositis (5 and 7 studies); peri-implantitis (5 to 6 and 9 studies) |
| Study designs | Prospective and retrospective cohort studies | 12 cohort studies (5 prospective, 7 retrospective) |
| Timing | Not specified | Follow-up 1 to 20 years |