Concept of Transmucosal Biological Complex and Its Clinical Implications in Dental Implantology

Dental implant rehabilitation has become the first-line treatment option for dentition defect and edentulism, and the transmucosal area is the core region affecting the long-term stability of implant rehabilitation. Previous research in this field has been mostly limited to a single histological or structural perspective. This paper innovatively proposes the concept of the Transmucosal Biological Complex (TBC), which integrates implant components (implant neck, abutment, and transmucosal part of the restoration) above the bone level and below the gingival margin with the surrounding hard and soft tissues as an integrated research object. By comprehensively reviewing the latest literature in the field of dental implantation, this paper expounds the composition system of the TBC, and systematically explores its key influencing factors, including implant neck design, type and stability of the implant-abutment connection, transmucosal materials of abutments/restorations, peri-implant soft tissue phenotype, and transmucosal design of the superstructure. For each influencing factor, the paper objectively clarifies its mechanism of action on the peri-implant marginal bone and soft tissues, and details its clinical advantages, application limitations, and existing research controversies in the field. This study aims to provide in-depth reference and guidance for clinical decision-making, technical application and scientific research in dental implantation, and to help improve the long-term clinical outcomes of implant rehabilitation and patients' quality of life.