title: Peri-implant mucosal dehiscence coverage with a modified semilunar coronary positioned flap in posterior maxilla: a case report.
abstract: Soft tissue dehiscence around dental implant has frequently been observed and it may lead to poor oral hygiene, especially around crowns that exhibit contours with prominent convexity. The present case demonstrates a peri-implant mucosal dehiscence coverage with modified semilunar coronary positioned flap (CPF) in #15 and 16. A semilunar partial-thickness incision was performed 7-10 mm apical from the facial gingival margin. Then, intrasulcular partial-thickness incision was tunneled to the semilunar incision. The tunnel preparation was extended interproximally under each papilla due to improvement of flap extension. Then, the tunneled flap was coronary positioned with a coronary-anchored suturing technique. Sub-epithelial connective tissue graft (SCTG) from the palate was inserted from the semilunar incision to the inside of the coronary positioned flap and sutured to stabilize the SCTG and supplemental site. Significant mucosal gain was achieved without any complication. The soft tissue volume was maintained at 9 months post-surgery, and the cleanability was improved. This technique has the potential in improving the graft survival and mucosa gain around implants.
authors.affiliation: Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Kanagawa-ku, Yokohama, Japan. ueno@kdu.ac.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ueno
authors.affiliation: Department of General Education, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
authors.forename: Jayanetti Asiri
authors.initials: JA
authors.lastname: Jayawardena
authors.affiliation: Unit of Oral and Maxillofacial Implantology, Tsurumi University Dental Hospital, Yokohama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kurokawa
keywords: Connective tissue graft; Coronary positioned flap; Dehiscence coverage; Dental implant