{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:13:26Z","timestamp":1790795606335,"version":"4.1.0"},"reference-count":125,"publisher":"Wiley","issue":"S20","license":[{"start":{"date-parts":[[2018,6,20]],"date-time":"2018-06-20T00:00:00Z","timestamp":1529452800000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clinic Periodontology"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of the present paper was to review factors and conditions that are associated with hard and soft\u2010tissue deficiencies at implant sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Hard\u2010 and soft\u2010tissue deficiencies at dental implants are common clinical findings. They can lead to complications and compromise implant survival and, hence, may require therapeutic interventions. It is, therefore, important to understand the etiology of hard and soft\u2010tissue deficiencies. Based on this understanding, strategies should be developed to correct hard and soft\u2010tissue deficiencies with the aim of improving clinical outcomes of implant therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>A large number of etiological factors have been identified that may lead to hard and soft\u2010tissue deficiencies. These factors include: 1) systemic diseases and conditions of the patients; 2) systemic medications; 3) processes of tissue healing; 4) tissue turnover and tissue response to clinical interventions; 5) trauma to orofacial structures; 6) local diseases affecting the teeth, the periodontium, the bone and the mucosa; 7) biomechanical factors; 8) tissue morphology and tissue phenotype; and 9) iatrogenic factors. These factors may appear as an isolated cause of hard and soft\u2010tissue defects or may appear in conjunction with other factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hard\u2010 and soft\u2010tissue deficiencies at implant sites may result from a multitude of factors. They encompass natural resorption processes following tooth extraction, trauma, infectious diseases such as periodontitis, peri\u2010implantitis, endodontic infections, growth and development, expansion of the sinus floor, anatomical preconditions, mechanical overload, thin soft tissues, lack of keratinized mucosa, malpositioning of implants, migration of teeth, lifelong growth, and systemic diseases. When more than one factor leading to hard and\/or soft\u2010tissue deficiencies appear together, the severity of the resulting condition may increase. Efforts should be made to better identify the relative importance of these etiological factors, and to develop strategies to counteract their negative effects on our patient's wellbeing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpe.12955","type":"journal-article","created":{"date-parts":[[2018,6,21]],"date-time":"2018-06-21T04:45:40Z","timestamp":1529556340000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":79,"title":["The etiology of hard\u2010 and soft\u2010tissue deficiencies at dental implants: A narrative review"],"prefix":"10.1111","volume":"45","author":[{"given":"Christoph H.F.","family":"H\u00e4mmerle","sequence":"first","affiliation":[{"name":"Chairman of the Clinic of Fixed and Removable Prosthodontics and Dental Material Science Center of Dental Medicine University of Zurich  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