Author
Dr. Michele Perelli
Turin, Italy
A young patient, female, had an implant positioned in site 22.
This picture shows the second surgical time with the uncovering of the screw. Note the free gingival
margin level around the healing abutment.
A provisional screw-retained crown was placed.
After 2 months an important periimplant soft tissue recession occurred. Note also the soft tissue’s concavity in the lateral view. This recession strongly compromised esthetic results.
Treating the implant as a tooth, mucogingival plastic surgery principles were applied. A splint- full thickness flap without vertical incisions was scalloped.
Periimplant soft tissue needed to be augmented in thickness and coronally replaced.
After partial- full thickness flap a free gingival epithelial-connective tissue graft was taken.
The graft was de-epithelized and placed apically to the adjacent teeth CEJ.
It was fixed to the recipient connective bed with glue (without sutures).
After periosteal incisions the flap was coronally repositioned and the surgical papillaes were sutured on the clinical papillaes. The free gingival margin was replaced at the same level of the contralateral tooth.
Sutures were removed after 15 days. Note the soft tissue margin level, the color and the external textures as well as the augmented thickness.
1 year follow-up radiography. The coronally advanced soft tissue is stable around the provisional crown with good blending with adjacent teeth soft tissues. Pink and White esthetic is gained.
Pre-op frontal view
Post-op frontal view
Pre-op lateral view
Post-op lateral view
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<br/>Author<br/> Dr. Michele Perelli<br/><br/>Turin, Italy<br/><br/><br/><br/>
<a href="#acc-3-4-d" data-parent="#accordion-3" data-toggle="collapse" class="accordion-toggle">Patient information
</a>
<img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드117.png" class=" vc_box_border_grey attachment-full" alt="슬라이드1" />
A young patient, female, had an implant positioned in site 22.</br>
This picture shows the second surgical time with the uncovering of the screw. Note the free gingival
margin level around the healing abutment.<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드26.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드26.png" class=" vc_box_border_grey attachment-full" alt="슬라이드2" /></a>
A provisional screw-retained crown was placed.<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드35.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드35.png" class=" vc_box_border_grey attachment-full" alt="슬라이드3" /></a>
After 2 months an important periimplant soft tissue recession occurred. Note also the soft tissue’s concavity in the lateral view. This recession strongly compromised esthetic results.<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드45.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드45.png" class=" vc_box_border_grey attachment-full" alt="슬라이드4" /></a>
Treating the implant as a tooth, mucogingival plastic surgery principles were applied. A splint- full thickness flap without vertical incisions was scalloped.<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드54.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드54.png" class=" vc_box_border_grey attachment-full" alt="슬라이드5" /></a>
Periimplant soft tissue needed to be augmented in thickness and coronally replaced.<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드65.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드65.png" class=" vc_box_border_grey attachment-full" alt="슬라이드6" /></a>
After partial- full thickness flap a free gingival epithelial-connective tissue graft was taken.<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드75.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드75.png" class=" vc_box_border_grey attachment-full" alt="슬라이드7" /></a>
The graft was de-epithelized and placed apically to the adjacent teeth CEJ.<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드85.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드85.png" class=" vc_box_border_grey attachment-full" alt="슬라이드8" /></a>
It was fixed to the recipient connective bed with glue (without sutures).<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드95.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드95.png" class=" vc_box_border_grey attachment-full" alt="슬라이드9" /></a>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드105.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드105.png" class=" vc_box_border_grey attachment-full" alt="슬라이드10" /></a>
After periosteal incisions the flap was coronally repositioned and the surgical papillaes were sutured on the clinical papillaes. The free gingival margin was replaced at the same level of the contralateral tooth.<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드118.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드118.png" class=" vc_box_border_grey attachment-full" alt="슬라이드11" /></a>
Sutures were removed after 15 days. Note the soft tissue margin level, the color and the external textures as well as the augmented thickness.<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드125.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드125.png" class=" vc_box_border_grey attachment-full" alt="슬라이드12" /></a>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드135.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드135.png" class=" vc_box_border_grey attachment-full" alt="슬라이드13" /></a>
1 year follow-up radiography. The coronally advanced soft tissue is stable around the provisional crown with good blending with adjacent teeth soft tissues. Pink and White esthetic is gained.
<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드144.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드144.png" class=" vc_box_border_grey attachment-full" alt="슬라이드14" /></a>
Pre-op frontal view
<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드154.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드154.png" class=" vc_box_border_grey attachment-full" alt="슬라이드15" /></a>
Post-op frontal view
<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드164.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드164.png" class=" vc_box_border_grey attachment-full" alt="슬라이드16" /></a>
Pre-op lateral view
<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드174.png"><img width="960" height="720" src="http://gaoforum.com/wp-content/uploads/2017/03/슬라이드174.png" class=" vc_box_border_grey attachment-full" alt="슬라이드17" /></a>
Post-op lateral view
<br/><br/>
Treating the implant as a tooth, mucogingival plastic surgery principles were applied. Periimplant soft tissue needed to be augmented in thickness and coronally replaced. http://gaoforum.com/mucogingival-plastic-surgery-applied-to-solve-peri-implant-soft-tissue-defects-in-esthetic-area/){kind=link}