A Novel Surgical Procedure for Coronally Repositioning of the Buccal Implant Mucosa Using Acellular Dermal Matrix: A Case Report

Abstract

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.

Implant Associated Soft Tissue Defects in the Anterior Maxilla

“…Currently, only few published reports could be found of such techniques after implant placement and definitive restoration. 5,6,16,26 One case report used a SCGT to correct the periimplant marginal tissue. 14 These researchers removed the definitive crown, placed a new abutment and grafted the abutment with a SCTG.…”

“…14 A single case report was found regarding ADM for periimplant recession coverage. 5 These authors grafted single periimplant recession with ADM after a triangular shaped incision and elevation of a partial thickness envelope. Partial coverage of the implant was stable up to 6 months.…”

“…Partial coverage of the implant was stable up to 6 months. 5 In a larger prospective cohort study (N ¼ 10), implants presenting with apically migrating soft tissues and long clinical crowns were treated with SCTG and coronal advancement with vertical releasing for dehiscence coverage. 4 The primary outcome measure was recession coverage.…”

“…Specifically, acellular dermal matrix (ADM) was identified as an adequate alternative to autogenous techniques for gingival augmentation. 2 Although there is an abundance of research concerning gingival augmentation around natural teeth, there are few studies investigating the outcomes of similar procedures around dental implants, [3][4][5] and none of these studies addressed grafting implants restored with definitive crowns.…”

Soft‐tissue dehiscence coverage at peri‐implant sites

“… coronally advanced flap, with or without (envelope coronally advanced flap) vertical releasing incisions with connective tissue graft: one randomized controlled clinical trial ; four prospective studies ; and five case reports . envelope flap/pouch/tunnel techniques with connective tissue graft or collagen matrix: five case reports and one prospective study . submerged techniques with or without connective tissue graft: two case reports . coronally advanced flap with acellular dermal matrix: one randomized controlled clinical trial and one case report . pedunculated connective tissue graft: one case report . free gingival graft: one case report . guided bone regeneration: one retrospective study . multiple surgical approaches in different surgical steps: three case reports . …”