Hi. My name is Dr. Balaji.
I'm the founder of ASA Academy of Soft and Hot Tissue Augmentation.
This, um, presentation about how important the soft tissue is around an implant.
The two main functions we look for the soft tissue to do around the implants is the first
one is aesthetic function like you see in the slide, and the most important next one is the
barrier function, which The barrier for the inflammation inflammatory cells to reach the
implant. So we need to do the soft tissue around the
implants. It doesn't matter whether you do bone graft or
not. The soft tissue health is very important for
two reasons, as I explained.
So if you look at the slide here, comparing to the normal tooth structure and then the implant,
in normal tooth structure, you have the soft tissue thin,
but there's no scar tissue there, lots of blood supply, so there are lots of infla inflammatory
reaction takes place and then it prevents the uh bacteria going into the root of the tooth
by junctional epithelium.
But we don't have. The junctional pithelium in the implant crown.
We have only the scar tissue and less blood supply, so less protection for the implant.
So we need to increase the thickness of the soft tissue to prevent the inflammatory cells
to reach the crest bone crest of the implant.
So when you probe the normal tooth, you will see there's a junctional epithelium which is
attached to the cementum of the root and then the enamel little bit of the enamel so that the
inflammatory cells doesn't reach the crust of the bone.
But if you probe the implant, the probe will go deep close to the crustal bone,
which tells us that there's no attachment in between the crown of the implant
and the soft tissue.
So what happens if you have a less thin soft tissue, as you can see in this picture here,
the diagram, the inflammatory cells, as I explained, reaches to the bone crest and then
the bone loss happens. Due to the bone loss, it reestablished 2
millimetre of soft tissue to prevent further bone loss,
but that is too late because it's already reached the mission surface of the implant
which caused further bone loss, so.
Please bear in mind when you place an implant, when you do a bone graft,
we need the thick soft tissue, Kane tissue, or thick soft tissue,
more than 2 millimetre, not only vertically, both horizontally and vertically,
to prevent bone loss, implantitis, or mucositis.
Thank you for listening.