title: Soft tissue grafting to improve implant esthetics.
abstract: Dental implants are becoming the treatment of choice to replace missing teeth, especially if the adjacent teeth are free of restorations. When minimal bone width is present, implant placement becomes a challenge and often resulting in recession and dehiscence around the implant that leads to subsequent gingival recession. To correct such defect, the author turned to soft tissue autografting and allografting to correct a buccal dehiscence around tooth #24 after a malpositioned implant placed by a different surgeon. A 25-year-old woman presented with the chief complaint of gingival recession and exposure of implant threads around tooth #24. The patient received three soft tissue grafting procedures to augment the gingival tissue. The first surgery included a connective tissue graft to increase the width of the keratinized gingival tissue. The second surgery included the use of autografting (connective tissue graft) to coronally position the soft tissue and achieve implant coverage. The third and final surgery included the use of allografting material Alloderm to increase and mask the implant from showing through the gingiva. Healing period was uneventful for the patient. After three surgical procedures, it appears that soft tissue grafting has increased the width and height of the gingiva surrounding the implant. The accomplished thickness of gingival tissue appeared to mask the showing of implant threads through the gingival tissue and allowed for achieving the desired esthetic that the patient desired. The aim of the study is to present a clinical case with soft tissue grafting procedures.
authors: Division of Periodontics, Marquette University, School of Dentistry, Milwaukee, WI, USA.
authors: Moawia M
authors: MM
authors: Kassab
keywords: allograft; case report; connective tissue; coronally positioned flap; dental implants
references: Dent Clin North Am. 2010 Jan;54(1):129-40
references: 20103476
references: J Periodontol. 2006 Dec;77(12):2070-9
references: 17209793
references: Angle Orthod. 1998 Apr;68(2):179-86
references: 9564429
references: Int J Periodontics Restorative Dent. 1994 Jun;14(3):216-27
references: 7995692
references: Int J Periodontics Restorative Dent. 1994 Aug;14(4):302-15
references: 7814223
references: Int J Periodontics Restorative Dent. 1985;5(2):14-37
references: 3858263
references: J Am Dent Assoc. 2002 Nov;133(11):1499-506; quiz 1540
references: 12462693
references: J Periodontol. 2002 Dec;73(12):1419-26
references: 12546091
references: J Can Dent Assoc. 2001 Jan;67(1):25-8
references: 11209502
references: Int Dent J. 1996 Apr;46(2):61-8
references: 8930675
references: Dent Clin North Am. 1996 Oct;40(4):911-43
references: 8886545
references: J Periodontol. 1985 Dec;56(12):715-20
references: 3866056
references: Dent Today. 2006 Jan;25(1):48, 50-2; quiz 52
references: 16471398
references: J Periodontol. 2002 Dec;73(12):1412-8
references: 12546090
references: J Periodontol. 1992 May;63(5):477-86
references: 1527693