Soft Tissue Management Around Dental Implants [June 2024]

Day One: (8h Theoretical)

CT graft for immediate implants in patients with different soft tissue phenotypes, architecture, and buccal bone dehiscence.

From biological to prosthetic management, factors that affect the stability of tissues around implants, what may influence bone loss and Peri-implantitis development around implants, and “when and when not to do soft tissue graft?”

Provisional design for immediate temporization in immediate implant cases and on grafted sites

How to develop, vertically and horizontally, the interproximal BonePeak in proximal immediate implants

Bone dehiscent sockets. How to use CTG in this situation

Conditioning cast and gingival impression Index

Day Two: (8h Hands on)

Harvesting techniques—How to simplify handling when collecting grafts, from small to large connective tissue grafts. How to minimize patient discomfort and surgical problems, improving healing and graft quality. From biology to surgical performance!

–              FGG/De-epithelialization

–              Sub-epithelial

–              Tuberosity Harvesting

Layering site preparation technique – Understanding the physiology of the tissues of the recipient site and how that can influence the phenotype modification of the grafted area – surgical maneuvers that can improve clinical results.

Intra-sulcular Tunneling and Modified Vista Approach for treatment of color compromised Implant and deficiency of buccal volume

Day Three: (8 Hours Lecture)

Simple flap Movements

Roll “S” flap

Doble Roll “S” flap

Roll “S” flap extended

Roll “S” flap spitted periosteum for bone graft

Soft Tissue Key Points for Implants already fixed in the Aesthetic Zone

Correction of Aesthetic Compromised Implants:

–              Color Compromised implant

–              Buccal Volume/emergence profile deficiency

–              Recession

–              Black Triangles and Papilla deficiency

Correction of Phenotypes Compromised Implants:

–              Volume Deficiencies

–              Attached Gingiva Deficiencies

–              Frenulum and short vestibule corrections

Soft Tissue Key Points for Healed Sockets in the Aesthetic Zone

–              Tunneling and modified vista

–              CAF

–              Vascularized Inter-positional Periosteal Connective Tissue Graft

–              Table Top CT Graft

The quality and design of the tissues surrounding implants are essential not only for long-term maintenance but also fundamental for aesthetic purposes.

Delivering “pink-free” restorative solutions over implants requires the full presence of the gingival contour, natural emergency profile, and respect for the aesthetic proportion ratio of crowns and bridges.

Achieving the perfect balance between pink and white contour is a key point.

Extractions can present an outstanding initial situation of tissue contour for immediacy. In these cases, preserving the gingival “frame” is the goal of our treatment.

But much more than the basic…  the knowledge of peri-implant remodelling after extraction, abutment/provisional biology and design, and minor surgical manoeuvres can boost aesthetic results and long-term tissue stability.

In cases of soft tissue deficiency around Osseointegrated functional implants, the surgeon must be prepared to identify, classify, and establish the correlated technique to fix phenotype and re-design the aesthetic contour to the ideal framing. Also, when the maintenance of the old implant is not ideal, the surgeon must know how to develop a strategy to replace the implant and/or create a healed site that allows the full reconstruction.