This case involves the Immediate implant placement of implants in #12 and #13 (recurrent caries) followed by a modified palatal roll for buccal contour augmentation. The case highlights an aspect of implant dentistry that often gets overlooked, namely the restoration of the buccal contour. The modified roll technique shown in this video was described by Tarnow and Scharf (Int J Periodontics Restorative Dent . 1992;12(5):415-25) and involves a partial thickness flap on the palatal, separation of the connective tissue from the palatal while still maintaining it’s attachment to the buccal tissue, and finally tucking of the pedicle beneath the buccal tissue to augment the soft tissue. All of the steps detailed above are covered in the video, as well as the post-op photographs showing the final results and restoration.
It makes me happy to know that someone else on this forum can appreciate the value of connective tissue around and implant. Too many people receive their implant training from a manufacturer and their solution to every anatomical imperfection is to place a graft and membrane as per the manufacturer that supplied the CE. Great job and I also appreciate seeing your confidence in your surgical technique which is apparent by your use of what appears to be my own personal favorite 4-0 Chromic Gut "Resorbable" sutures!!!
Thanks for the nice words. Definitely agree- it’s more than just placing a screw in bone and slapping a crown on it. I love using connective tissue for peri implant restoration. The body loves its own stuff!
This is a nice result for the technique described. Without x-rays, these teeth appear to be restorable without being extracted