| Popis: |
Missing teeth are involved with the atrophy of the buccal alveolar bone. The teeth to be extracted are often accompanied by bone and/or soft tissue defects. In most cases, an implant can be placed in the correct position with or without bone augmentation procedure. Nevertheless, the soft tissue often remains an esthetic concern due to a discrepancy in facial mucosa level and curvature, absent or incomplete papillae, missing root prominence, and, particularly, due to the bluish gingival color and tissue texture without stippling. The clinical cases present the vascularized interpositional periosteal-connective tissue flap technique for periimplant site development in the aesthetic area prior to implant placement and at the time of implant placement. Connected via a pedicle to the palate, the vascularized graft maintains its own blood supply, with almost no volume loss postoperatively. The graft remains vital even when covering poorly vascularized recipient sites like bone blocks, membranes or implant covering screws. It can be used for periimplant site development prior to implant placement or at the time of implant placement with concomitant bone grafting to achieve adequate soft tissue volume with one surgical intervention, avoiding extensive undermining of the adjacent soft tissue. These case presentations demonstrate that the use of a pediculated connective tissue graft may be an effective way to achieve an excellent aesthetic outcome in implant surgery concerning all parameters included within PES. |
