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Demographic and clinical data (age, gender, smoking, oral hygiene, implant function duration) were recorded. In the clinical evaluation, VD, keratinized mucosa (KM) width and phenotype, and periodontal\/peri-implant parameters (modified plaque index (mPI), modified gingival index (mGI), probing pocket depth (PD), bleeding on probing (BOP), gingival recession, and suppuration) were recorded. Implants were divided into two groups based on VD: shallow VD (\u2264\u20094\u00a0mm) and adequate VD (&gt;\u20094\u00a0mm). The primary endpoint was the presence (yes\/no) of peri-implantitis at the implant level according to clinical and radiographic criteria, reported as prevalence in the study population. Radiographic bone loss was measured on panoramic radiographs. The VD groups were compared using the Mann\u2013Whitney U and \u03c7\u00b2 tests; within-patient clustering was accounted for using GEE logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      A total of 336 implants from 65 patients were evaluated. VD\u2009\u2264\u20094\u00a0mm was detected in 26.5% of implants, and &gt;\u20094\u00a0mm in 73.5%. According to clinical diagnosis, 39.9% of implants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009134) had peri-implant health, 34.5% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009116) had peri-implant mucositis, and 25.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200986) had peri-implantitis. In the shallow VD group, mPI, mGI, BOP, PD, gingival recession, radiographic bone loss, and suppuration were found to be higher than in the adequate VD group in exploratory bivariate analyses (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In the multivariate GEE analysis, VD\u2009\u2264\u20094\u00a0mm was independently associated with peri-implantitis (OR\u2009=\u20092.405; 95% CI: 1.233\u20134.690;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010). Additionally, the odds of peri-implantitis were increased in those with implant duration of 5\u201310 years (OR\u2009=\u20094.026;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044), and the maxillary anterior region showed a lower likelihood of peri-implantitis compared to the mandibular posterior region (OR\u2009=\u20090.409;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Shallow VD was associated with gingival recession, MBL, and the presence of peri-implantitis, along with higher plaque accumulation and soft tissue inflammation. The findings suggest that adequate VD, as a component of the peri-implant phenotype, may be associated with the maintenance of peri-implant health. In particular, in shallow vestibules with a KM width\u2009&lt;\u20092\u00a0mm and a thin mucosal phenotype, approaches such as vestibuloplasty and\/or soft tissue augmentation may be considered in selected cases to support plaque control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical significance<\/jats:title>\n                    <jats:p>Our findings suggest that evaluating VD as part of the peri-implant phenotype may help identify conditions that make maintaining hygiene difficult in areas with shallow vestibules and facilitate discussion of mucogingival approach options in selected cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-026-06807-w","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:27:04Z","timestamp":1773880024000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Shallow vestibular depth as a risk indicator for peri-implantitis: a retrospective analysis of 336 implants"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0459-8318","authenticated-orcid":false,"given":"B\u00fclent","family":"Ula\u015ftan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9850-0780","authenticated-orcid":false,"given":"Ahmet","family":"Da\u011f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1199-1706","authenticated-orcid":false,"given":"Hatice","family":"Orta\u00e7","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"issue":"Suppl 1","key":"6807_CR1","doi-asserted-by":"publisher","first-page":"S1014","DOI":"10.4103\/jpbs.jpbs_788_21","volume":"14","author":"G Chahal","year":"2022","unstructured":"Chahal G, Yadav BK, Thakur RK, Saini R, Kumar M, Saurabh K (2022) Clinicoradiographic evaluation of long-term efficacy and risk factors associated with dental implants used for full mouth rehabilitation. 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