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ABSTRACT
Immediate implant placement and provisionalization has been considered as a preservative procedure when replacing failing teeth, especially in the esthetic zone. Nevertheless, an average facial gingival tissue recession of 1 mm is still common after one year of function. Furthermore, facial gingival recession of thin periodontal biotype seems to be more pronounced than that of thick biotype. Biotype conversion around both natural teeth and implants with subepithelial connective tissue graft has been advocated, and the resulting tissues appear to be more resistant to recession. A technique combining subepithelial connective tissue graft and immediate implant placement and provisionalization is devised to achieve a more stable peri-implant tissue in thin biotype situations. This article describes the surgical and prosthodontic approach of this procedure as well as its clinical rationale.
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Notes on contributors
Kitichai Rungcharassaeng
Kitichai Rungcharassaeng, DDS, MS, is associate professor, Department of Restorative Dentistry; resident, Department of Orthodontics, Loma Linda University School of Dentistry.
Jaime L. Lozada
Jaime L. Lozada, DDS, is professor, Department of Restorative Dentistry, and director of Post-Graduate Program in Implant Dentistry, Loma Linda University School of Dentistry.