Tissue preservation strategies for fostering long-term soft and hard tissue stability

As placement of functionally stable dental implants has become routine, concerns have shifted to maintenance of crestal bone and soft tissue stability. This article proposes the development of a tissue preservation philosophy to avoid crestal bone loss and gingival recession and thus foster long-term esthetics around implants. Pillars of this philosophy must include avoidance or minimization of an implant-abutment microgap and micromovement, use of platform switching, appropriate implant positioning relative to the bone crest, and preservation of the papillae when placing both single and multiple implants.