Peri‐Implant Soft Tissue Phenotype Remodeling Following Peri‐Implantitis Surgery: A Prospective Profilometric Analysis

ABSTRACT Aim To characterize longitudinal changes in peri‐implant soft tissue phenotype following surgical therapy of peri‐implantitis. Materials and Methods Twenty‐one patients with superimposable intraoral scan datasets at four timepoints—pre‐operative (T0), intra‐operative (T1), 3‐month (T2), and 12‐month (T3) follow‐up—were included. Soft tissue parameters including mean mucosal thickness (mMT), supracrestal tissue height (STH), keratinized mucosal area, and volumetric shrinkage were assessed. Clinical parameters, including probing pocket depth (PPD), bleeding on probing (BOP), plaque index (PI), and gingival index (GI), were recorded at T0, T2, and T3. Treatment success was defined using composite clinical criteria at 12 months. Results Significant reductions in mMT, STH, and keratinized mucosal area were observed over 12 months in both successful and non‐successful treatment groups. mMT decreased from 1.45 mm to 0.36 mm in the successful group and from 2.83 mm to 1.38 mm in the non‐successful group. STH converged to approximately 3 mm in both groups at T3. Keratinized mucosal area also decreased over time, with no significant between‐group difference ( p = 0.721). The most pronounced changes occurred during the first 3 months, with volumetric shrinkage of 30.2 and 31.6 mm 3 at T2 in the successful and non‐successful groups, respectively ( p < 0.001). The magnitude of soft tissue phenotype changes did not differ significantly between groups for most parameters ( p = 0.522). STH at T3 showed a negative association with BOP (coefficient = −0.08, p = 0.049), whereas baseline keratinized mucosal area positively predicted residual mMT at T3 (coefficient = 0.024, p < 0.001). Conclusions Surgical therapy of peri‐implantitis resulted in significant reductions of soft tissue phenotype, and baseline keratinized mucosal area was positively associated with residual mMT at 12 months. No statistically significant association was observed between the magnitude of soft tissue shrinkage and clinical outcomes.