title: Plastic surgery at the time of membrane removal around mandibular endosseous implants: a modified technique for implant uncovering.
abstract: Removal of barrier membranes may complicate second-stage implant surgery, particularly in mandibular areas characterized by a shallow vestibule and minimal amount of keratinized tissue. A new surgical technique that permits implant exposure and membrane removal combined with a plastic procedure to improve soft tissue quality both buccally and lingually is presented. A midcrestal incision preserving the keratinized tissue available on the lingual side is designed. A double-layer flap is elevated, allowing membrane removal. The inner, full-thickness layer is then sutured back into place, thus protecting the regenerated bone and allowing a recipient bed for a free gingival graft. The outer, partial-thickness flap is sutured apically, thus deepening the vestibule. The advantages and technical aspects of the procedure are discussed.
authors.affiliation: lulandi@gol.grosseto.it
authors.forename: L
authors.initials: L
authors.lastname: Landi
authors.forename: D
authors.initials: D
authors.lastname: Sabatucci
mesh_terms: D018786:Bone Substitutes / Q000627:therapeutic use; D016025:Bone Transplantation; D003238:Connective Tissue / Q000601:surgery; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D005260:Female; D005881:Gingiva / Q000637:transplantation; D005893:Gingivoplasty; D016557:Guided Tissue Regeneration, Periodontal / Q000295:instrumentation*; D006801:Humans; D008334:Mandible / Q000601:surgery*; D008567:Membranes, Artificial; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D013524:Surgical Flaps; D013536:Suture Techniques; D014727:Vestibuloplasty; D014945:Wound Healing
chemical_list: D018786:Bone Substitutes; D015921:Dental Implants; D008567:Membranes, Artificial; D011138:Polytetrafluoroethylene