Digital soft tissue mapping for peri-implant soft tissue augmentation procedures

Dr. Giorgio Tabanella

DDS, MS Diplomate of the American Board of Periodontology, O.R.E.C.-Oral Reconstruction and Education Center, Rome, Italy

Abstract

As long as the implants are inserted in a 3D prosthetic-driven direction and surrounded by a minimum volume of bone matrix, the implant treatment can be safely considered as long-lasting. However, the fact that an implant is properly functioning is not necessarily associated with success. In fact, many dental implants can present esthetic or functional alterations in the soft tissue morphology and texture that may jeopardize the success rate. Soft tissue defects around dental implants, such as papilla or volume loss, peri-implant recession and alterations of the ridge color and/or texture, lead to critical esthetic and functional critical issues. Treatments of these defects around implants are more demanding than in teeth because peri-implant tissue exhibits different anatomical and histological characteristics. Recent studies have shown that the peri-implant mucosa can play a major role in the sealing of the implant platform, thus preventing bacterial ingrowth. A good quality and quantity of the mucosa is also critical for achieving biomimetics and pink esthetics. It has been reported that about one-third of the inserted implants may then require a connective tissue graft. However, this approach could be considered to be too invasive when multiple implants need to be treated with mucogingival plastic procedures. The “Buccal Pedicle Flap” and its modifications will be presented as a novel technique to boost the peri-implant mucosa without the need for invasive procedures, thus allowing the dentist to obtain the desiderable mucosa volume and quality. This approach would lead to more stable tissues, no peri-implant bone loss or peri-implantitis and ultimately a higher success rate in modern implant dentistry.Finally, recent studies will be presented to describe digital soft tissue mapping to monitor the stability of the augmented soft tissue collar but also to properly plan the reconstruction of the pink esthetics.

OBJECTIVE:

• understand the importance of the peri-implant mucosa

• be able to detect the critical numbers for mucosa health

• evaluate the surgical alternatives to boost the peri-implant mucosa

• understand in details the critical steps to perform the “Buccal Pedicle Flap”

• obtain a full understanding of the concept of mucosa integration and soft tissue sealing

• understand how to prevent or treat complications and failures in dental medicine

• learn how to use digital technology for soft tissue mapping and monitoring