Abstract: Presence of adequate keratinized tissue around dental implants helps oral hygiene maintenance and enhances esthetic blending. However, whether mucosa graft is necessary for deficient posterior area (keratinized mucosa width ≤ 2 mm) remains controversy. This paper mainly discusses the effect of keratinized tissue deficiency in the posterior jaw on periimplant indexes, and the pros and cons of keratinized mucosa graft, and implant long stability. It is concluded that mucosa graft is not necessary, while oral hygiene maintenance, regular followup and individual consideration of treatment strategies are necessary.