Tissue-level implant
Also known as: Soft-tissue level implant, Transmucosal implant, TL implant
An implant with an integral polished transmucosal collar, so that the implant–abutment interface sits above the crestal bone at the level of the soft tissue.
Key facts
| Classification | A one-piece or transmucosal design in which the connection to the abutment is located at a distance from the bone, at tissue levelVerified spec[1] |
|---|---|
| How it differs | Differs from a bone-level implant, in which the implant–abutment connection is positioned at the bone crestVerified spec[1] |
| Typical use | Often chosen in the posterior segments, where the collar is not visible and a supragingival restoration margin makes cement removal and later cleaning simpler. |
| Clinical evidence | A 2020 systematic review of 20 studies found that, in most of them, marginal bone loss did not differ significantly between tissue-level and bone-level implants over one to five yearsClinical evidence |
| Limitations | The transmucosal height is fixed at manufacture, so the collar cannot be adjusted to suit the gum thickness of the individual site. Where the gum is thin and visible, the polished collar can become exposed, which is why these designs are used more cautiously in the aesthetic zone. |
Overview
A tissue-level implant carries its own smooth collar, so the implant emerges through the gum in one piece and the joint with the crown sits above the bone. Historically this was the design that made one-stage surgery routine, because the implant head is already accessible when healing finishes. Its limitation is the mirror image of its strength: the collar height is decided in the factory rather than at the chairside, so it suits sites where a slightly supragingival margin is acceptable. A common misconception is that tissue-level implants are inherently kinder to bone; the comparative radiographic evidence to date does not show a consistent difference, and the choice is usually made on site, visibility and restorative preference rather than on bone loss.
Sources
Numbers match the citations beside each claim above.
Clinical evidence
- [1]Radiological Outcomes of Bone-Level and Tissue-Level Dental Implants: Systematic Review — International Journal of Environmental Research and Public Health (PMC), 2020. Accessed 2026-07-21.