Gum recession and a visible metal edge after implant treatment? Three levels of assessment: appearance, cleaning, and hard and soft tissues｜證據鏈

FAQ

Does a visible metal edge after implant treatment mean that the implant has failed?

Not necessarily. In the literature, ‘visible metal’ corresponds to two different situations: **soft-tissue recession** (a positional change that exposes the abutment or implant neck) and **colour showing through** (thin mucosa allowing the colour of the underlying metal to show). The latter does not necessarily involve recession. Notably, a 5-year randomised controlled trial found a significant difference in aesthetic scores between zirconia and titanium abutments, but **clinical performance was similar and bone levels did not change significantly** [F4]. This shows that aesthetics and implant health can be separate issues. **The actual diagnosis must be made by a dentist on the basis of a clinical examination and any necessary imaging.**

インプラント治療後に金属の縁が見えるのは、インプラントが失敗したということですか。 — 必ずしもそうではありません。文献上、「金属が見える」状態は 2つに分かれます。**軟組織の退縮**（位置が変化し、アバットメントまたはインプラント頸部が露出すること）と、**色の透過**（粘膜が薄く、その下にある金属の色が透けて見えること）です。後者は退縮を伴わない場合もあります。注目すべき点として、5年間のランダム化比較試験では、ジルコニア製とチタン製アバットメントの審美評価に有意差がありましたが、**臨床的な成績は同等で、骨の高さに有意な変化はありませんでした** [F4]。これは、審美上の問題とインプラントの健康状態を分けて考えられることを示しています。**実際の判断には、歯科医師による臨床検査と必要な画像検査が必要です。**

Does a visible metal edge after implant treatment mean that the implant has failed? — Not necessarily. In the literature, ‘visible metal’ corresponds to two different situations: **soft-tissue recession** (a positional change that exposes the abutment or implant neck) and **colour showing through** (thin mucosa allowing the colour of the underlying metal to show). The latter does not necessarily involve recession. Notably, a 5-year randomised controlled trial found a significant difference in aesthetic scores between zirconia and titanium abutments, but **clinical performance was similar and bone levels did not change significantly** [F4]. This shows that aesthetics and implant health can be separate issues. **The actual diagnosis must be made by a dentist on the basis of a clinical examination and any necessary imaging.**