Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2010 Sep 17:2:101-7.
doi: 10.2147/CCIDEN.S13478. Print 2010.

Soft tissue grafting to improve implant esthetics

Moawia M Kassab  1
Affiliations
Case Reports

Soft tissue grafting to improve implant esthetics

Moawia M Kassab. Clin Cosmet Investig Dent. .

Abstract

Dental implants are becoming the treatment of choice to replace missing teeth, especially if the adjacent teeth are free of restorations. When minimal bone width is present, implant placement becomes a challenge and often resulting in recession and dehiscence around the implant that leads to subsequent gingival recession. To correct such defect, the author turned to soft tissue autografting and allografting to correct a buccal dehiscence around tooth #24 after a malpositioned implant placed by a different surgeon. A 25-year-old woman presented with the chief complaint of gingival recession and exposure of implant threads around tooth #24. The patient received three soft tissue grafting procedures to augment the gingival tissue. The first surgery included a connective tissue graft to increase the width of the keratinized gingival tissue. The second surgery included the use of autografting (connective tissue graft) to coronally position the soft tissue and achieve implant coverage. The third and final surgery included the use of allografting material Alloderm to increase and mask the implant from showing through the gingiva. Healing period was uneventful for the patient. After three surgical procedures, it appears that soft tissue grafting has increased the width and height of the gingiva surrounding the implant. The accomplished thickness of gingival tissue appeared to mask the showing of implant threads through the gingival tissue and allowed for achieving the desired esthetic that the patient desired. The aim of the study is to present a clinical case with soft tissue grafting procedures.

Keywords: allograft; case report; connective tissue; coronally positioned flap; dental implants.

PubMed Disclaimer

Figures

Figure 1A
Figure 1A
Preoperative view showing malpositioned implant.
Figure 1B
Figure 1B
Preoperative X-ray.
Figure 1C
Figure 1C
Connective tissue graft in place.
Figure 1D
Figure 1D
Donor graft collected from unilateral palate.
Figure 1E
Figure 1E
Graft sutured in place.
Figure 1F
Figure 1F
10 days postoperative.
Figure 1G
Figure 1G
6 months postoperative.
Figure 2A
Figure 2A
Second surgery preoperative.
Figure 2B
Figure 2B
Partial thickness flap reflected keeping the papilla intact.
Figure 2C
Figure 2C
Partial thickness flap reflected beyond the mucogingival junction.
Figure 2D
Figure 2D
Suturing after surgery.
Figure 2E
Figure 2E
Two weeks postoperation.
Figure 2F
Figure 2F
Six months postoperation.
Figure 3A
Figure 3A
Third surgery preoperative.
Figure 3B
Figure 3B
Partial thickness flap utilizing periodontal knife.
Figure 3C
Figure 3C
Releasing incisions to facilitate placement of Alloderm.
Figure 3D
Figure 3D
Alloderm material hydrated.
Figure 3E
Figure 3E
Alloderm sutured in place.
Figure 3F
Figure 3F
Nine months postoperation.
See this image and copyright information in PMC

References

    1. Mantzikos T, Shamus I. Case report: forced eruption and implant site development. Angle Orthod. 1996;68(2):179–186. - PubMed
    1. Schweizer CM, Schlegel AK, Rudzki-Janson I. Endosseous dental implants in orthodontic therapy. Int Dent J. 1996;46(2):61–68. - PubMed
    1. Richardson G, Russell KA. Congenitally missing maxillary lateral incisors and orthodontic treatment considerations for the single tooth implant. J Can Dent Assoc. 2001;67(1):25–28. - PubMed
    1. Shroff B, Siegel SM, Feldman S, Siegel SC. Combined orthodontic and prosthetic therapy. Special considerations. Dent Clin North Am. 1996;40(4):911–943. - PubMed
    1. Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol. 1985;56:715–720. - PubMed

Publication types

LinkOut - more resources