Esthetic complications in implant dentistry

Abstract Esthetic complications in implant dentistry have become a significant consideration for patients and practitioners. This review presents an appraisal on the current knowledge of the physiological peri‐implant soft‐tissue dimensions and factors that may compromise peri‐implant tissue esthetics. Factors such as papilla fill adjacent to the implant and midfacial mucosal height are critical parameters that determine the esthetic success of implant‐supported restorations. Papilla fill adjacent to a single dental implant appears to depend upon the clinical attachment level of the neighboring tooth. A horizontal inter‐implant distance of at least 3 mm is necessary to ensure optimal interproximal mucosal embrasure between two adjacent implants in the anterior maxilla. In cases where implants cannot be placed at least 3 mm apart, a single implant with a cantilever bridge should be considered. Buccolingual implant positioning plays a major role in midfacial mucosal height. Soft‐tissue volume grafting following immediate implant placement in the presence of a thin soft‐tissue phenotype or simultaneous to surgical peri‐implantitis therapy might help to overcome facial mucosa recession.