A prosthetic-surgical approach for aesthetic treatment of peri-implant soft tissue defects: A case report

Mohamad Adib Jaafar; Sharul Nisha  Ali; Siti Nurqissa  Mustafa

doi:10.31436/ijohs.v5i2.311

Authors

Mohamad Adib Jaafar Periodontal Specialist Clinic of Jalan Perak, Ministry of Health Malaysia, 11600, Jelutong, Penang, Malaysia & Periodontal Specialist Clinic of Mak Mandin, Ministry of Health Malaysia, 13400, Butterworth, Penang, Malaysia.
Sharul Nisha Ali Periodontal Specialist Clinic of Mak Mandin, Ministry of Health Malaysia, 13400, Butterworth, Penang, Malaysia.
Siti Nurqissa Mustafa Periodontal Specialist Clinic of Mak Mandin, Ministry of Health Malaysia, 13400, Butterworth, Penang, Malaysia.

DOI:

https://doi.org/10.31436/ijohs.v5i2.311

Keywords:

augmentation, complication, connective tissue, dental implant, recession

Abstract

Peri-implant soft tissue defects (PSTD) in the esthetic zone affect approximately 54% cases of post-implant insertion, leading to aesthetic concerns and increasing the risk of peri-implantitis. Various surgical techniques are aimed at addressing these issues, but the outcomes can be unpredictable, especially for severely mispositioned implants. This report details a combined prosthetic and surgical approach to treat a severely angulated single central maxillary implant with mid-labial mucosal recession. A 38-year-old female expressed dissatisfaction with the implant at 21 area, which appeared elongated due to peri-implant mucosal recession of almost 4 mm. Treatment involved two phases: 1) prosthetic phase involves replacing the original crown of implant at 21 area with a temporary crown to promote mucosal growth and 2) surgical phase that involves soft tissue surgery three months later using an envelope flap technique at the recipient site and a connective tissue graft harvested from the palate. Upon three months after the surgery, full coverage with thick mucosal tissue was achieved, and a new zirconia crown was placed. The outcome remained stable throughout the nine-month follow-up. This case demonstrates that PSTD in angulated implants in the esthetic zone can be effectively treated through a combination of prosthetic and surgical modalities.

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