title: Esthetic buccal flap for correction of buccal fenestration defects during flapless immediate implant surgery.
abstract: BACKGROUND
  Clinically, it is a tremendous challenge to create natural gingival esthetics after immediate or delayed implant placement. Hence, flapless immediate implant surgery has been proposed to overcome the shortfalls of these techniques. Nonetheless, one of the major limitations for this technique is its inability to correct localized horizontal/vertical deficiency, dehiscence, or fenestration without jeopardizing esthetic outcomes. Therefore, the aim of this paper was to present a new flap design, the esthetic buccal flap (EBF), aimed at overcoming this potential problem while maintaining the optimal esthetic appearance.
  
  
  METHODS
  Five consecutively EBF-treated patients with simultaneous implant placement were included in this pilot case study. Clinical measurements were taken at the time of prosthesis insertion and 6 and 12 months after surgery. These included soft tissue height, papillae appearance, scar appearance, and mid-buccal probing depth.
  
  
  RESULTS
  Data obtained from this pilot case study showed that soft tissue height was preserved, and papillae appearance remained the same as at presurgery. No scar tissue was reported in any cases. Mid-buccal probing depths remained consistent throughout the study.
  
  
  CONCLUSIONS
  The results indicate that EBF, together with simultaneously guided bone augmentation, allows clinicians to correct apical buccal fenestration defects while maintaining the supraosseous soft tissue during flapless immediate implant surgery.
authors.affiliation: Department of Periodontology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Marius
authors.initials: M
authors.lastname: Steigmann
authors.forename: Hom-Lay
authors.initials: HL
authors.lastname: Wang
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000209:etiology / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods; D001861:Bone Regeneration; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D004955:Esthetics, Dental; D005260:Female; D005881:Gingiva / Q000601:surgery; D005893:Gingivoplasty / Q000379:methods*; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013524:Surgical Flaps; D014081:Tooth Extraction / Q000009:adverse effects; D020390:Tooth Socket / Q000601:surgery*