Focal areas of gingival hyperplasia surrounding the transmucosal portions of titanium implants have been attributed to poor hygiene, lack of attached gingival tissues, and titanium allergy. Following mandibular vestibuloplasty and placement of a split-thickness skin graft, two of five patients developed persistent proliferation of the epithelial tissue surrounding endosseous CP titanium dental implants. In both circumstances, traditional gingivectomy procedures, chemotherapeutic agents, and aggressive oral hygiene measures failed to adequately control the hyperplastic response. Following replacement of the titanium abutments with custom-fabricated gold abutments, the epithelial condition appeared to return to normal.
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