title: The ramp mattress suture: a new suturing technique combined with a surgical procedure to obtain papillae between implants in the buccal area.
abstract: This article has been written to show the opportunity and eventually the predictability to obtain new papillae between implants and a better esthetic result by the use of a new suturing technique. After raising a full-thickness flap from the palatal to the vestibular side, it can be stabilized in such a position using a new suturing technique (ramp mattress suture) to apply pressure and tearing forces on the flap in an apicocoronal direction at the vestibular site and an opposite traction in a coronoapical direction at the palatal site. The ramp mattress suture seems to be capable of pulling the flap in an apicocoronal direction in the vestibular site, as well as in a coronoapical direction in the palatal site. Thanks to such a mattress suture, it will be possible to obtain a more coronal gingival margin. After an adequate healing period of approximately 5 weeks, a vestibular scalloped gingivectomy is performed around the vestibular surface of the abutment to create either a scalloped gingival margin or interproximal papillae only in the vestibular area, forming a gingival ramp in a palatovestibular direction to reasonably reduce the residual increased vestibular depth and optimize the esthetic result. Eight patients, for a total of 56 papillae, were treated with this new suturing technique. The esthetic results satisfied both clinician and patient expectations.
authors.affiliation: Dental School of Florence, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Tinti
authors.forename: Stefano
authors.initials: S
authors.lastname: Parma-Benfenati
mesh_terms: D000328:Adult; D015921:Dental Implants; D005260:Female; D005890:Gingivectomy; D005893:Gingivoplasty / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013536:Suture Techniques
chemical_list: D015921:Dental Implants