Periodontal tissues and their counterparts around endosseous implants

New technology coupled with a better understanding of tissue biology has played a key role in restoring the somewhat tarnished image of implant dentistry. Thanks to carefully conducted longitudinal studies, it has now become clear that the replacement of missing teeth by artificial implants integrated into the living tissues of the jaws is a predictable procedure, as long as certain guidelines are followed in the manufacture of the implant, in its placement, in its eventual functional loading, and in its maintenance (Adell et al.. 1981, Alberktsson 1988, Albrektsson et al. 1988, Babbush et al. 1986, Kirsch & Mentag 1986, Smithloff 1986, Smithloff & Fritz 1987). Yet, functioal success for a natural tooth is dependent on a number of anatomic, physiologic, and environmental considerations which differ in some important respects from those that insure the functional success of an implant. In this paper, we review the anatomic features of the natural dentition with emphasis on the periodontal tissues, and contrast these characteristics with those that exist around well-integrated endosseous implants.