Skip to main content

Soft Tissue Management for Implants in theĀ Aesthetic Zone

  • Chapter
  • First Online:
Implants in the Aesthetic Zone
  • 1436 Accesses

Abstract

While implant success depends on a multitude of factors, soft tissue management is critical to the aesthetic success of anterior implant tooth replacement in the partially edentulous patient. The peri-implant soft tissue appearance should emulate and match natural periodontal aesthetics. Ideally, peri-implant soft tissues blend imperceptibly with and mimic the surrounding periodontal soft tissues of the natural dentition. Achieving that goal requires an understanding of periodontal and peri-implant anatomy and an appreciation for factors that influence soft tissue contours around teeth and dental implant restorations. In addition to mastering surgical objectives and techniques, clinicians must be able to evaluate and accurately diagnose the existing periodontal condition.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Gargiulo AW, Wentz FM, Orban B. Dimensions and relations of the dentogingival junction in humans. J Periodontol. 1961;32:261ā€“7.

    ArticleĀ  Google ScholarĀ 

  2. Kan JY, Rungcharassaeng K, Umezu K, Kois JC. Dimensions of peri-implant mucosa: an evaluation of maxillary anterior single implants in humans. J Periodontol. 2003;74:557ā€“62.

    ArticleĀ  Google ScholarĀ 

  3. Vacek JS, Gher ME, Assad DA, Richardson AC, Giambarresi LI. The dimensions of the human dentogingival junction. Int J Periodontics Restorative Dent. 1994;14:154ā€“65.

    PubMedĀ  Google ScholarĀ 

  4. Tarnow DP, Magner AW, Fletcher P. The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla. J Periodontol. 1992;63:995ā€“6.

    ArticleĀ  Google ScholarĀ 

  5. Martegani P, Silvestri M, Mascarello F, Scipioni T, Ghezzi C, Rota C, Cattaneo V. Morphometric study of the interproximal unit in the esthetic region to correlate anatomic variables affecting the aspect of soft tissue embrasure space. J Periodontol. 2007;78:2260ā€“5.

    ArticleĀ  Google ScholarĀ 

  6. Cho HS, Jang HS, Kim DK, Park JC, Kim HJ, Choi SH, Kim CK, Kim BO. The effects of interproximal distance between roots on the existence of interdental papillae according to the distance from the contact point to the alveolar crest. J Periodontol. 2006;77:1651ā€“7.

    ArticleĀ  Google ScholarĀ 

  7. Schoenbaum TR, Klokkevold PR, Chang YY. Immediate implant-supported provisional restoration with a root-form pontic for the replacement of two adjacent anterior maxillary teeth: a clinical report. J Prosthet Dent. 2013;109:277ā€“82.

    ArticleĀ  Google ScholarĀ 

  8. Buser D, Bornstein MM, Weber HP, Grutter L, Schmid B, Belser UC. Early implant placement with simultaneous guided bone regeneration following single-tooth extraction in the esthetic zone: a cross-sectional, retrospective study in 45 subjects with a 2- to 4-year follow-up. J Periodontol. 2008;79:1773ā€“81.

    ArticleĀ  Google ScholarĀ 

  9. Chen ST, Darby IB, Reynolds EC, Clement JG. Immediate implant placement postextraction without flap elevation. J Periodontol. 2009;80:163ā€“72.

    ArticleĀ  Google ScholarĀ 

  10. Kan JY, Rungcharassaeng K, Lozada J. Immediate placement and provisionalization of maxillary anterior single implants: 1-year prospective study. Int J Oral Maxillofac Implants. 2003;18:31ā€“9.

    PubMedĀ  Google ScholarĀ 

  11. Klokkevold PR, Han TJ, Camargo PM. Aesthetic management of extractions for implant site development: delayed versus staged implant placement. Pract Periodontics Aesthet Dent. 1999;11:603ā€“10. quiz 612.

    PubMedĀ  Google ScholarĀ 

  12. Azzi R, Takei HH, Etienne D, Carranza FA. Root coverage and papilla reconstruction using autogenous osseous and connective tissue grafts. Int J Periodontics Restorative Dent. 2001;21:141ā€“7.

    PubMedĀ  Google ScholarĀ 

  13. Han TJ, Takei HH. Progress in gingival papilla reconstruction. Periodontol. 1996;11:65ā€“8.

    ArticleĀ  Google ScholarĀ 

  14. Takei HH, Han TJ, Carranza FA Jr, Kenney EB, Lekovic V. Flap technique for periodontal bone implants. Papilla preservation technique. J Periodontol. 1985;56:204ā€“10.

    ArticleĀ  Google ScholarĀ 

  15. Lekovic V, Kenney EB, Weinlaender M, Han T, Klokkevold P, Nedic M, Orsini M. A bone regenerative approach to alveolar ridge maintenance following tooth extraction. Report of 10 cases. J Periodontol. 1997;68:563ā€“70.

    ArticleĀ  Google ScholarĀ 

  16. Araujo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol. 2005;32:212ā€“8.

    ArticleĀ  Google ScholarĀ 

  17. Araujo MG, Wennstrom JL, Lindhe J. Modeling of the buccal and lingual bone walls of fresh extraction sites following implant installation. Clin Oral Implants Res. 2006;17:606ā€“14.

    ArticleĀ  Google ScholarĀ 

  18. Hammerle CH, Araujo MG, Simion M, Osteology Consensus G. Evidence-based knowledge on the biology and treatment of extraction sockets. Clin Oral Implants Res. 2012;23(Suppl 5):80ā€“2.

    ArticleĀ  Google ScholarĀ 

  19. Tarnow D, Elian N, Fletcher P, Froum S, Magner A, Cho SC, Salama M, Salama H, Garber DA. Vertical distance from the crest of bone to the height of the interproximal papilla between adjacent implants. J Periodontol. 2003;74:1785ā€“8.

    ArticleĀ  Google ScholarĀ 

  20. Kois JC. Predictable single-tooth peri-implant esthetics: five diagnostic keys. Compend Contin Educ Dent. 2004;25:895ā€“6. 898, 900 passim; quiz 906ā€“897.

    PubMedĀ  Google ScholarĀ 

  21. Benic GI, Mokti M, Chen CJ, Weber HP, Hammerle CH, Gallucci GO. Dimensions of buccal bone and mucosa at immediately placed implants after 7 years: a clinical and cone beam computed tomography study. Clin Oral Implants Res. 2012;23:560ā€“6.

    ArticleĀ  Google ScholarĀ 

  22. Miron RJ, Dard M, Weinreb M. Enamel matrix derivative, inflammation and soft tissue wound healing. J Periodontal Res. 2015;50:555ā€“69.

    ArticleĀ  Google ScholarĀ 

  23. Rasperini G, Roccuzzo M, Francetti L, Acunzo R, Consonni D, Silvestri M. Subepithelial connective tissue graft for treatment of gingival recessions with and without enamel matrix derivative: a multicenter, randomized controlled clinical trial. Int J Periodontics Restorative Dent. 2011;31:133ā€“9.

    PubMedĀ  Google ScholarĀ 

  24. Hehn J, Schwenk T, Striegel M, Schlee M. The effect of PRF (platelet-rich fibrin) inserted with a split-flap technique on soft tissue thickening and initial marginal bone loss around implants: results of a randomized, controlled clinical trial. Int J Implant Dent. 2016;2:13.

    ArticleĀ  Google ScholarĀ 

  25. Han TJ, Jeong CW. Bone and crescent shaped free gingival grafting for anterior immediate implant placement: technique and case report. J Implant Adv Clin Dent. 2009;1:23ā€“33.

    ArticleĀ  Google ScholarĀ 

  26. Araujo MG, Sukekava F, Wennstrom JL, Lindhe J. Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog. J Clin Periodontol. 2005;32:645ā€“52.

    ArticleĀ  Google ScholarĀ 

  27. Nevins M, Camelo M, De Paoli S, Friedland B, Schenk RK, Parma-Benfenati S, Simion M, Tinti C, Wagenberg B. A study of the fate of the buccal wall of extraction sockets of teeth with prominent roots. Int J Periodontics Restorative Dent. 2006;26:19ā€“29.

    PubMedĀ  Google ScholarĀ 

  28. Chiapasco M, Consolo U, Bianchi A, Ronchi P. Alveolar distraction osteogenesis for the correction of vertically deficient edentulous ridges: a multicenter prospective study on humans. Int J Oral Maxillofac Implants. 2004;19:399ā€“407.

    PubMedĀ  Google ScholarĀ 

  29. Covani U, Cornelini R, Barone A. Bucco-lingual bone remodeling around implants placed into immediate extraction sockets: a case series. J Periodontol. 2003;74:268ā€“73.

    ArticleĀ  Google ScholarĀ 

  30. Schropp L, Kostopoulos L, Wenzel A. Bone healing following immediate versus delayed placement of titanium implants into extraction sockets: a prospective clinical study. Int J Oral Maxillofac Implants. 2003;18:189ā€“99.

    PubMedĀ  Google ScholarĀ 

  31. Allen EP, Gainza CS, Farthing GG, Newbold DA. Improved technique for localized ridge augmentation. A report of 21 cases. J Periodontol. 1985;56:195ā€“9.

    ArticleĀ  Google ScholarĀ 

  32. Seibert JS. Treatment of moderate localized alveolar ridge defects. Preventive and reconstructive concepts in therapy. Dent Clin N Am. 1993;37:265ā€“80.

    PubMedĀ  Google ScholarĀ 

  33. Kan JY, Rungcharassaeng K, Lozada JL. Bilaminar subepithelial connective tissue grafts for immediate implant placement and provisionalization in the esthetic zone. J Calif Dent Assoc. 2005;33:865ā€“71.

    PubMedĀ  Google ScholarĀ 

  34. Khzam N, Arora H, Kim P, Fisher A, Mattheos N, Ivanovski S. Systematic review of soft tissue alterations and esthetic outcomes following immediate implant placement and restoration of single implants in the anterior maxilla. J Periodontol. 2015;86:1321ā€“30.

    ArticleĀ  Google ScholarĀ 

  35. Kan JY, Rungcharassaeng K. Site development for anterior single implant esthetics: the dentulous site. Compend Contin Educ Dent. 2001;22:221ā€“6. 228, 230-221; quiz 232.

    PubMedĀ  Google ScholarĀ 

  36. Bengazi F, Wennstrom JL, Lekholm U. Recession of the soft tissue margin at oral implants. A 2-year longitudinal prospective study. Clin Oral Implants Res. 1996;7:303ā€“10.

    ArticleĀ  Google ScholarĀ 

  37. Grunder U. Stability of the mucosal topography around single-tooth implants and adjacent teeth: 1-year results. Int J Periodontics Restorative Dent. 2000;20:11ā€“7.

    PubMedĀ  Google ScholarĀ 

  38. Nozawa T, Enomoto H, Tsurumaki S, Ito K. Biologic height-width ratio of the buccal supra-implant mucosa. Eur J Esthet Dent. 2006;1:208ā€“14.

    PubMedĀ  Google ScholarĀ 

  39. Kan JY, Rungcharassaeng K, Lozada JL, Zimmerman G. Facial gingival tissue stability following immediate placement and provisionalization of maxillary anterior single implants: a 2- to 8-year follow-up. Int J Oral Maxillofac Implants. 2011;26:179ā€“87.

    PubMedĀ  Google ScholarĀ 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Perry R. Klokkevold .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

Ā© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Klokkevold, P.R. (2019). Soft Tissue Management for Implants in theĀ Aesthetic Zone. In: Schoenbaum, T. (eds) Implants in the Aesthetic Zone. Springer, Cham. https://doi.org/10.1007/978-3-319-72601-4_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-72601-4_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-72600-7

  • Online ISBN: 978-3-319-72601-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics