Soft tissue reconstruction / thickening
Today, implant placement is a frequent treatment procedure following tooth extraction. The success of implant therapy however depends on several factors: treatment planning, surgical technique and management of hard and soft tissues.
Peri-implant soft tissue reconstruction/ thickening is a method used to restore lost soft tissue volumes caused by i.e. infection/ diseases, traumatic events, surgical procedures and more. To improve or restore the original soft tissue condition, autologous connective tissue grafts (gold standard) are mostly applied but soft tissue substitutes, such as mucoderm® are nowadays valid alternatives to treat soft tissue defects either alone or in combination with bone grafting materials. Promising is also the combination with enamel-matrix derivative (Emdogain®) to improve wound healing following soft tissue reconstruction/thickening.
Soft tissue volume
Thin biotypes are particularly predisposed to mucosal recessions after implant placement; therefore, preoperative evaluation of the existing bone volume and the surrounding soft tissue conditions are crucial. In case of thin biotypes (<2 mm) soft tissue thickening is recommended and can be performed in horizontal and/ or vertical dimension, respectively. It is proofed that a volume of >2mm around implants leads to higher papilla scores and helps to prevent mucosal recession as well as crestal bone loss.
In the last years a number of studies highlighted the importance of a sufficiently broad band of keratinized tissue around implants and its role in maintaining lower plaque accumulation and tissue inflammation. Therefore, augmentation of soft tissues help to restore both, hard and soft tissue profile. This favours long‐term implant stability, aesthetics and with the latter patient satisfaction.
Mucosal and Connective tissue grafts
Modern techniques of plastic-aesthetic surgery ensure a satisfactory regeneration of soft tissue deficiencies in the majority of cases. Free mucosal and subepithelial connective tissue grafts are still gold standard. Despite their clinical success, their use is associated with significant disadvantages, such as second surgical side, increased post-operative pain, and higher risk for infections. To overcome these issues, alternatives such as allogenic or xenogeneic collagen matrices (e.g. mucoderm®) offer valid alternatives.