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Fundamentals of Esthetic Implant Dentistry
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Figure 5.48. A. Intraoral view showing the outlines of the second-stage surgical entry in black dots. B. Implants exposed. Note the amount of palatal tissue to be moved. C. The midbuccal incision release is performed with a scissor.
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Figure 5.48. D. The midbuccal-releasing incisions. E. The flap sutured and the papillae are being sutured to the sides of the wound. F. Three weeks’ post healing showing improved healing result.
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Figure 5.49. A. A mucoperiosteal flap is being used to expose the implant. B. The midbuccal incision is used and the flap sutured bilaterally. C. Three months’ postrestorative showing the efficacy of the midbuccal release technique.
any flap design should allow for excess tissue formation. The overcorrection of the soft tissue in the second-stage surgery can be performed via the use of connective tissue grafts, sliding flaps, and rotational flaps. After enough time to allow complete tissue remodeling and stabilization, the undesirable tissue can be excised or trimmed to its optimal size. (See Figure 5.51A.)
9. Soft Tissue Refining and Profiling: As a result of the second-stage surgery, soft tissue healing might not be optimized due to numerous reasons, either systemic or local. Even when the previous steps have been taken into consideration, there are other contributing factors to healing, such as the patient’s oral habits. The resulting poor healing might be manifested as tissue tags, dimples, roughness,