A novel surgical procedure for coronally repositioning of the buccal implant mucosa using acellular dermal matrix: a case report.
BACKGROUND
This case report describes a surgical procedure for coronally advancing the peri-implant mucosa to treat a soft tissue dehiscence in a single-tooth implant-supported restoration in combination with an acellular dermal matrix graft.


METHODS
The patient was a 41-year-old systemically healthy, non-smoking female. Her chief complaint pertained to the unesthetic appearance of her right lateral upper incisor, caused by recession of the mucosal margin. On examination, a 3-mm recession could be observed. The periodontium was classified as thin. A 2-mm band of keratinized peri-implant mucosa was present. Keratinized gingiva was approximately 6 mm at adjacent areas. The surgical technique included a novel incision design to coronally position the flap over an acellular dermal matrix graft.


RESULTS
Partial coverage of the recession was achieved. After a 6-month period, tissues appeared thicker than preoperatively, with no bleeding on probing and no probing depth >2 mm. The patient was satisfied with the overall treatment result.


CONCLUSIONS
This case report shows the possibility of achieving partial soft tissue coverage over an implant-supported restoration with the combined use of an acellular dermal matrix and a coronally positioned flap. A novel technique is presented that allowed advancing the flap over the graft in a single-tooth restoration where enough keratinized tissue was present preoperatively.
Department of Periodontology, University of Santiago de Compostela, Santiago de Compostela, Spain. s_mareque@hotmail.com
Santiago
S
Mareque-Bueno
D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use*; D019250:Dental Implants, Single-Tooth; D005260:Female; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000601:surgery*; D005893:Gingivoplasty / Q000379:methods*; D006801:Humans; D007180:Incisor; D008437:Maxilla; D017060:Patient Satisfaction; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
D001672:Biocompatible Materials; D003094:Collagen