Influence of Attached Gingiva Width on Peri-implant Bone Loss: A 5-year Retrospective Study

Background This study aimed to assess the demographic, clinical, and radiographic characteristics of patients who received dental implants over a five-year period, and to explore the relationship between the width of attached gingiva and peri-implant marginal bone loss.. Methods A total of 107 patients with 330 dental implants placed at the Department of Periodontology, Faculty of Dentistry, Eskişehir Osmangazi University, were retrospectively evaluated. Recorded parameters included age, sex, smoking habits, plaque index (PI), gingival index (GI), probing depth, and width of attached gingiva. Marginal bone loss was measured on standardized panoramic radiographs, and implants were grouped according to attached gingiva width (< 2 mm or ≥ 2 mm) and bone loss severity (< 1 mm, 1–2 mm, 2–3 mm, > 3 mm). Statistical analyses were performed using chi-square and independent samples t-tests, with the significance level set at p < 0.05. Results Among the implants examined, 79.7% had an attached gingiva width of ≥ 2 mm, while 45.8% exhibited less than 1 mm of bone loss. Mean bone loss was significantly greater in implants with < 2 mm gingiva (2.17 mm) compared to those with ≥ 2 mm (1.64 mm). Decreased gingiva width was associated with older age and smoking, and implants with narrower gingiva showed higher PI and GI scores. Conclusion A limited width of attached gingiva appears to be linked to greater peri-implant bone loss. Preserving at least 2 mm of keratinized attached gingiva around implants may be important for maintaining peri-implant tissue health and long-term stability. Prospective multicenter studies are recommended to further substantiate these findings and establish optimal soft tissue management strategies.