**Dimension and Structures of Biological Seal of Peri-Implant Tissues**

[109] Lindgren M, Löfmark S, Edlund C, Huovinen P, Jalava J. Prolonged impact of a oneweek course of clindamycin on Enterococcus spp. in human normal microbiota. Scand

[110] Granowitz EV, Brown RB. Antibiotic adverse reactions and drug interactions. Crit Care

[111] Lockhart PB, Blizzard J, Maslow AL, Brennan MT, Sasser H, Carew J. Drug cost implications for antibiotic prophylaxis for dental procedures. Oral Surg Oral Med Oral

[112] Sullivan A, Edlund C, Nord CE. Effect of antimicrobial agents on the ecological balance

[113] Nord CE. Studies on the ecological impact of antibiotics. Eur J Clin Microbiol Infect Dis.

[114] Van der Waaij D, Nord CE. Development and persistence of multi-resistance to antibiotics in bacteria; an analysis and a new approach to this urgent problem. Int J

[115] Huddleston JR. Horizontal gene transfer in the human gastrointestinal tract: Potential

[116] weforum. Global Risks, 9th Ed. Available from: http://www3weforumorg/docs/

[117] O'Neill J. Antimicrobial Resistance: Tackling a Crisis for the Health and Wealth of

[118] Powell CA, Mealey BL, Deas DE, McDonnell HT, Moritz AJ. Post-surgical infections: Prevalence associated with various periodontal surgical procedures. J Periodontol.

[119] Antibiotic Prophylaxis for Surgical Procedures, Summary and Conclusions. SBU report

spread of antibiotic resistance genes. Infect Drug Resist. 2014;7:167–76.

J Infect Dis. 2009;41(3):215–9.

38 Dental Implantology and Biomaterial

Clin. 2008;24(2):421–42, xi.

1990;9(7):517–8.

Nations. 2014.

2005;76(3):329–33.

no: 200. 2010.

Pathol Oral Radiol Endodontol. 2013;115(3):345–53.

Antimicrob Agents. 2000;16(3):191–7.

WEF\_GlobalRisks\_Report\_2014pdf. 2014.

of human microflora. Lancet Infect Dis. 2001;1(2):101–14.

Wen Lin Chai, Masfueh Razali and Wei Cheong Ngeow

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/63950

#### **Abstract**

Over the years, improved understanding of the nature of bone-implant interface is among the important contributors to the success of osseointegration in modern dental implantology. The focus has since shifted to the assessment of the soft tissue-implant interface to better understand the mechanism of biological seal in the transmucosal region. The importance of peri-implant mucosal region lies in the need to establish a tight seal that isolates implant and the bone from the oral environment via epithelial and connective tissue attachment, thus preventing ingrowth of bacterial plaque. Many factors may influence the soft tissue attachment at this peri-implant interface. In this chapter, the dimension of peri-implant tissues and the factors affecting the biological seal, namely surface topography and physicochemical properties, are discussed. The review also looks into the impact of the type of materials and surface modifications of dental implant, all of which may influence the formation of biological seal of soft tissue around the dental implant.

**Keywords:** implant-soft tissue interface, biological seal, peri-implant tissues, surface topography, three-dimensional oral mucosal model
