Clinical Outcome of a New Surgical Technique for the Treatment of Peri-Implant Dehiscence in the Esthetic Area. A Case Report

Norberto Quispe-López,Javier Montero,Carmen García-Faria,Yasmina Guadilla,Jesús Mena-Álvarez,Pablo Garrido Martínez

doi:10.3390/app11114781

Norberto Quispe-López, Javier Montero + Show 4 more

Open Access

https://doi.org/10.3390/app11114781

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Abstract

This study describes the clinical and esthetic outcome of n apical surgical treatment on peri-implant soft tissue dehiscence in an implant with a poor prognosis in the esthetic area. The patient presented a compromised situation of clinical attachment loss both in the 1.2 implant and in the adjacent teeth. A biphasic approach consisted firstly of a connective tissue graft accessed by apical and then, 11 months later, a palatal flap technique plus a connective tissue graft. After 20 months of healing, surgical approaches without vertical releasing incisions showed a gain in recession reduction over the implant ranging from 0.3 to 2.7 mm (CI 95%), in addition to a gain in width (2 mm) and thickness (2.3 mm) of the keratinized mucosa. With respect to the white esthetic score, 4 points were gained, and with respect to the pink esthetic score, 3 points were gained. With the use of the apical approach technique and the palatal flap technique, satisfactory results are obtained in the treatment of recessions on implants, improving the amount of keratinized mucosa and the esthetic result in an objective manner in the anterior area.

Highlights

The concept of osseointegration was originally defined by Brånemark et al, as a direct structural and functional connection between living bone tissue and the surface of an implant [1]
Loss of osseointegration prior to prosthetic loading [9]. In addition to these biological and biomechanical complications of direct cause, there are different clinical complications linked to the non-use of classical knowledge in implantology and periodontology [10]
These complications, especially in the esthetic area, can be reduced thanks to the new digital tools that we have at our disposal [11]

Summary

Introduction

The concept of osseointegration was originally defined by Brånemark et al, as a direct structural and functional connection between living bone tissue and the surface of an implant [1]. In addition to these biological and biomechanical complications of direct cause, there are different clinical complications linked to the non-use of classical knowledge in implantology and periodontology [10]. Today, these complications, especially in the esthetic area, can be reduced thanks to the new digital tools that we have at our disposal [11].

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