Bilaminar subepithelial connective tissue grafts for immediate implant placement and provisionalization in the esthetic zone.
Immediate implant placement and provisionalization has been considered as a preservative procedure when replacing failing teeth, especially in the esthetic zone. Nevertheless, an average facial gingival tissue recession of 1 mm is still common after one year of function. Furthermore, facial gingival recession of thin periodontal biotype seems to be more pronounced than that of thick biotype. Biotype conversion around both natural teeth and implants with subepithelial connective tissue graft has been advocated, and the resulting tissues appear to be more resistant to recession. A technique combining subepithelial connective tissue graft and immediate implant placement and provisionalization is devised to achieve a more stable peri-implant tissue in thin biotype situations. This article describes the surgical and prosthodontic approach of this procedure as well as its clinical rationale.
Kan
Joseph Y K
JY
Department of Restorative Dentistry, Loma Linda University School of Dentistry, CA 92350, USA.
Rungcharassaeng
Kitichai
K
Lozada
Jaime L
JL
D000328:Adult; D003238:Connective Tissue / Q000637:transplantation*; D003758:Dental Implantation, Endosseous / Q000009:adverse effects / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D003831:Denture, Partial, Immediate; D003833:Denture, Partial, Temporary; D005260:Female; D005881:Gingiva / Q000637:transplantation*; D005889:Gingival Recession / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D007180:Incisor / Q000601:surgery; D008437:Maxilla; D008875:Middle Aged; D014081:Tooth Extraction / Q000009:adverse effects