Soft Tissue Closure of Grafted Extraction Sockets in the Anterior Maxilla: A Modified Palatal Pedicle Connective Tissue Flap Technique

Chaar, Edgard El; Oshman, Sarah; Cicero, Giuseppe; Castaño, Alejandro Carrero; Soltani, Leila; Lee, Yoonjung Nicole

doi:10.11607/prd.2746

Cited by 13 publications

(18 citation statements)

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“…Meanwhile Chu et al [31] subclassified previously reported extraction socket classification [29] and comprised extraction sites with bone defect. Extraction socket classification performed by El Chaar et al [32] subclassified extraction socket in accordance with buccal bone plate loss, interproximal bone height, apical topography and soft tissue biotype.…”

Section: Resultsmentioning

confidence: 99%

“…Alveolar ridge preservation procedure has been suggested in cases with severe loss of buccal bone plate (> 50%) [48]. Patients with thin soft tissue biotype and buccal bone loss from 25% to 50% a delayed implant placement with socket preservation is recommended [32]. The horizontal bone loss of the socket walls is evaluated: the distance between the tip of the socket labial plate and coronal border of the buccal bone of adjacent regions.…”

Section: Discussionmentioning

confidence: 99%

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Morphological Classification of Extraction Sockets and Clinical Decision Tree for Socket Preservation/Augmentation after Tooth Extraction: a Systematic Review

Juodžbalys¹,

Stumbras²,

Goyushov³

et al. 2019

JOMR

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ObjectivesThe aim of present study was to review current literature concerning extraction socket classification immediately following tooth extraction and the rationales for socket preservation/augmentation procedures and with reference to it suggest novel clinical decision tree for extraction socket preservation/augmentation in aesthetic and non-aesthetic area.Material and MethodsThe search protocol used the electronic MEDLINE (PubMed) and EMBASE databases for articles published between January 1 2009 and May 1 2019. The search included only human studies published in English. Outcomes were the indications and reasons for socket preservation/augmentation and classification of extraction sockets.ResultsTen studies fulfilled the inclusion criteria and were selected for the study. Although there are various types of extraction socket classifications none of them could completely evaluate all morphological parameters of alveolar ridge. Furthermore, present study revealed that indications for extraction socket preservation/augmentation have wider spectrum than socket morphology and are related to surrounding tissue anatomy or dental implantation operation indications and timing. Based on currently proposed extraction socket classifications and rationales, a novel decision tree for extraction socket preservation/augmentation immediately after tooth extraction in aesthetic and non-aesthetic area was suggested.ConclusionsThe need of extraction socket preservation/augmentation immediately after tooth extraction should be determined by the aesthetic, functional and risk-related viewpoint. A novel clinical decision tree for extraction socket preservation/augmentation immediately after tooth extraction in aesthetic and non-aesthetic zones can be useful tool in socket preservation/augmentation procedures.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Morphological Classification of Extraction Sockets and Clinical Decision Tree for Socket Preservation/Augmentation after Tooth Extraction: a Systematic Review

Juodžbalys¹,

Stumbras²,

Goyushov³

et al. 2019

JOMR

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show abstract

“…The main variation to conventional free connective tissue graft is the harvesting of the CTG. During the preparation of the pedicle, the connective tissue graft below the primary flap is freed from the rest of the palatal tissue on three sides, while one side remains attached to it [45, 73,[75][76][77].…”

Section: Connective Tissue Pedicle Flapsmentioning

confidence: 99%

“…Furthermore, VIP-CTG can be used for simultaneous soft and hard tissue augmentation procedures, reducing patient treatment time and morbidity. This procedure is indicated before implant placement, concomitant with implant placement, or during the implant osseointegration period [45, 75,76,84] or pontic site development (Figures 12-18) [44,73,74].…”

Section: Connective Tissue Pedicle Flapsmentioning

confidence: 99%

Peri-Implant Soft Tissue Augmentation

Blašković¹,

Blašković²

2022

Dentistry

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The peri-implant soft tissue (PIS) augmentation procedure has become an integral part of implant-prosthetic rehabilitation. Minimal width of keratinized mucosa (KM) of 2 mm is deemed necessary to facilitate oral hygiene maintenance around the implant and provide hard and soft peri-implant tissue stability. PIS thickness of at least 2 mm is recommended to achieve the esthetic appearance and prevent recessions around implant prosthetic rehabilitation. The autogenous soft tissue grafts can be divided into two groups based on their histological composition—free gingival graft (FGG) and connective tissue graft (CTG). FGG graft is used mainly to increase the width of keratinized mucosa while CTG augment the thickness of PIS. Both grafts are harvested from the same anatomical region—the palate. Alternatively, they can be harvested from the maxillary tuberosity. Soft tissue grafts can be also harvested as pedicle grafts, in case when the soft tissue graft remains attached to the donor site by one side preserving the blood supply from the donor region. Clinically this will result in less shrinkage of the graft postoperatively, improving the outcome of the augmentation procedure. To bypass the drawback connected with FGG or CTG harvesting, substitutional soft tissue grafts have been developed.

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“…Nemcovsky et al preconized the use of a split-thickness 15 and full-thickness 16 rotated palatal flap for primary closure after immediate implant placement. In addition, rotated pedicle flaps have been used for the purpose of soft tissue closure of grafted extraction sockets 17 and closure of alveolar defects after bone grafting. 18 Advantages of the use of the vascularized interpositional periosteal-connective tissue (VIP-CT) graft are excellent blood supply, less morbidity, primary closure of donor and recipient bed, and patient acceptance due to donor and recipient site involving a single surgical site.…”

Section: Introductionmentioning

confidence: 99%

Optimizing Anterior Implant Esthetics With a Vascularized Interpositional Periosteal Connective Tissue Graft for Ridge Augmentation: A Case Report

Ferreira

Barreto

Zini

2018

Journal of Oral Implantology

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Achieving excellence in anterior rehabilitations requires close cooperation between the periodontist and the prosthodontist. Many techniques can be used to restore the lost alveolar hard and soft tissues. The more severe the peri-implant defect, the higher the challenge and lower the predictability of the procedure. The present case consists of Seibert Class III with malaligned implants in the esthetic zone resolved with a cost-modified treatment plan to reestablish esthetics in the anterior maxilla using a rotated palatal flap. The vascularized interpositional periosteal connective tissue graft was effective in augmenting the soft tissue in the esthetic zone and remained stable over a 2-year period. Additional long-term clinical studies are necessary to support these results.

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Soft Tissue Closure of Grafted Extraction Sockets in the Anterior Maxilla: A Modified Palatal Pedicle Connective Tissue Flap Technique

Cited by 13 publications

References 0 publications

Morphological Classification of Extraction Sockets and Clinical Decision Tree for Socket Preservation/Augmentation after Tooth Extraction: a Systematic Review

Morphological Classification of Extraction Sockets and Clinical Decision Tree for Socket Preservation/Augmentation after Tooth Extraction: a Systematic Review

Peri-Implant Soft Tissue Augmentation

Optimizing Anterior Implant Esthetics With a Vascularized Interpositional Periosteal Connective Tissue Graft for Ridge Augmentation: A Case Report

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