Why the Gumline Around Your Dental Implant Matters — and What We Do About It

By Dr. Regina Yunusov, DDS Owner, Cedar Park Dental Wellness

When we think of a beautiful smile, we often focus on the white of the teeth. But the “pink”—the gums around those teeth or implants—plays an equally vital role. A crown or implant may be perfectly functional, but if the surrounding tissue doesn’t align with the adjacent natural teeth, the result can look unbalanced or unnatural. This happens more often than you’d think—and yet it’s often overlooked.

What is a peri-implant soft-tissue deficiency?

Around a natural tooth, when gum tissue recedes or the margin shifts downward, we call that gingival recession—a “mucogingival” condition tied to anatomy (thin gum, anatomic factors) or habits (for example, aggressive brushing). Around an implant, though, the situation is different: the gum margin can sit too low, be too thin, or simply not match the neighboring teeth—and yet the implant threads may not be exposed and the implant may be fully integrated. We call this a peri-implant soft-tissue deficiency. The key point: the problem is often prosthetic or surgical placement + soft-tissue management—rather than the patient’s anatomy alone.

Why it matters to you

• Alignment matters: Imagine an invisible line connecting the gingival (gum) peaks of the two natural teeth on either side of an implant. The gumline of the implant-crown should ideally sit along that line. If it’s lower (apical) or bulging outward, the eye sees it.

• Thickness matters: Even if the margin is well-aligned, if the tissue is very thin you risk seeing a gray shadow of the implant or abutment underneath. Studies show that when soft tissue thickness is less than about 2 mm, inflammation (which occupies about 1.5 mm of vertical space) may compromise the margin, leading to visible recession or metal show-through.

• Patient perception: A patient with gingival recession around a tooth often understands the cause (anatomic, brushing habits). With implant-site issues, patients often feel something went wrong in the treatment. Clear patient education helps alleviate concerns and aligns expectations.

How we classify and treat it

At Cedar Park Dental Wellness, we use a simple decision-tree approach:

1. Is the implant 3-dimensionally well placed?

   • If yes, the issue is primarily soft-tissue quantity or emergence profile (our easier group).

   • If no, then the placement itself might be the limiting factor (our more complex group).

2. Soft-tissue quantity & profile:

   • Class 1: Margin at correct level, but tissue too thin (lack of thickness).

   • Class 2: Margin apically displaced, but the crown/implant emergence is acceptable.

   • Class 3: Margin apically displaced AND the crown is profiled outside the ideal corridor—but implant head is still well placed.

   • Class 4: Worst case: margin apical, crown profile poor, and implant head is too buccal (outside ideal position).

3. Sub-classification based on interproximal tissue (i.e., the papillae between the teeth):

   • A: Healthy papillae height (≥3 mm above ideal margin).

   • B: Reduced papillae (<3 mm).

   • C: One or more papillae at or below the ideal margin (most challenging).

4. Treatment path accordingly:

   • Good implant position + good interproximal tissue (Class 1, A or B) → Soft-tissue grafting (connective tissue graft), flap management, aim for ~2 mm thickness.

   • Reduced interproximal tissue (B or C) → Pre-surgical prosthetic phase (temporarizing, narrowing abutment, short crown) to allow tissue to recover, then grafting + conditioning.

   • Poor implant position (Class 4) → Advanced cases: layered grafting (“platform technique”) to rebuild volume, or in some cases implant removal and re-placement in correct 3-D position.

What we do at our clinic

• We measure and plan using digital diagnostics & 3-D imaging for precision placement and tissue planning.

• For surgical correction where indicated, we raise a flap, use a connective-tissue graft (or in selected cases a collagen matrix) to achieve ~2 mm of final tissue thickness.

• After healing (typically 3–4 months or more), we move into a conditioning phase: the provisional crown is used to shape the soft-tissue contour (buccal scallop, papillae height) before final crown delivery.

• Patient comfort and maintenance matter: We ensure you have excellent home-care instructions, interdental cleaning (super-floss) around the implant, and general recall every 3 months to protect the result.

What you should ask your dentist

• How will the implant crown gum margin align with the neighbouring natural teeth?

• What is the predicted soft-tissue thickness, and how will you achieve it?

• If the implant is already placed, how will you correct any margin or thickness discrepancy?

• What is the timeline (many of these corrections take 6-12 months)? What will my smile look like in the meantime (yes, maybe a temporary crown that looks less than ideal, but for long-term gain)?

• What maintenance will I need after the correction?

Final thoughts for our patients

At Cedar Park Dental Wellness, we believe that a smile isn’t just about the tooth or the crown—it’s the harmony between the white and the pink. When we align the gum margin properly and rebuild the tissue volume thoughtfully, implants don’t just work—they look just like the natural tooth beside them. If you’ve ever looked in the mirror and thought, “That implant looks different from the rest,” let’s talk about it. With the right planning, technique, and patience, we can help you restore not just your function, but your confidence in your smile.

Schedule a Complimentary Consultation Call us at 512-640-8240 or request an appointment online at www.cedarparkdentalwellness.com — let’s talk about how we can give your implant-site the soft-tissue support it deserves.

Dr. Regina Yunusov, DDS Cedar Park Dental Wellness – 251 N Bell Blvd Suite 106, Cedar Park, TX 78613 Committed to precision, comfort, and your best smile.