Clinical outcome of a new surgical technique for the treatment of peri-implant dehiscence in the esthetic area. A case report

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.