Soft-Tissue Augmentation Using a Porcine-Derived Collagen Matrix to Correct a Labial Soft-Tissue Defect Following Extraction of a Maxillary Incisor
In this case, Shakeel Shahdad employs a two-layer matrix to repair a soft-tissue defect in a post-extraction healed site prior to implant placement with simultaneous guided bone regeneration. This approach resulted in a gain of keratinized peri-implant mucosa with optimal shade and texture. Soft-tissue defects are often encountered prior to implant placement and may result in deficient attached keratinized mucosa, which unless corrected will yield less than ideal esthetic outcomes. The presence of keratinized mucosa has been proposed as one of the prognostic factors for the survival of dental implants (Adell and coworkers 1986) with reported greater reductions in gingival and plaque indices after increasing the width of keratinized mucosa by soft-tissue augmentation (Giannobile and coworkers 2018; Thoma and coworkers 2018).
General information
Case Type | |
---|---|
Jaw | Maxilla |
Area | Anterior |
# of Teeth | 1 |
# of Implants | 1 |
Type of Implants | One-Piece |
Attachment | One-Piece |
Bone Augmentation | Horizontal|Simultaneous |
---|---|
Augmentation Materials | Autogenous chips|Xenogenous|Membrane |
Guided Surgery | No |
Soft Tissue Grafting | Staged |
Abutment Type | - |
Prosthesis Type | FDP |
Esthetic Risk Assessment
Esthetic Risk Factors | Low | Medium | High |
---|---|---|---|
Medical Status | Healthy | Compromised | |
Smoking Habit | Non-smoker | Light smoker (< 10 cigarettes per day) | Heavy smoker (>= 10 cigarettes per day) |
Patient's Esthetic Expectations | Low | Medium | High |
Lip Line | No exposure of papillae | Exposure of papillae | Full exposure of mucosa margin |
Periodontal Phenotype | Low-scalloped, thick | Medium-scalloped, medium-thick | High-scalloped, thin |
Shape of Tooth Crowns | Rectangular | Triangular | |
Infection at Implant Site | None | Chronic | Acute |
Bone Level at Adjacent Teeth | <= 5 mm to contact point | 5.5 to 6.5 mm to contact point | > 7 mm to contact point |
Prosthodontic Status of Neighboring Teeth | Virgin | Restored | |
Width of Edentulous Span | 1 tooth (>= 7 mm) | 1 tooth (< 7 mm) | 2 teeth or more |
Soft Tissue Anatomy | Intact | Defective | |
Bone Volume | Horizontally and vertically sufficient | Horizontally deficient | Deficient vertically or deficient vertically AND horizontally |
* General SAC assessment modifiers that are also part of the ERA. To avoid redundancy they are listed in this section even if no complete ERA has been made.
** Not applicable to the ERA of immediate placement cases and replaced by "Socket Integrity" listed below under "Surgical SAC Classification". For all other placement types this value is a classification determinant and listed here even if no complete ERA has been made.
Surgical SAC classification
SAC Level | Advanced |
---|---|
Defining Characteristics | One missing tooth to be replaced by an implant-borne prosthesis |
Modality | Modality |
Placement Protocol | Early or late implant placement |
Tooth Site | Tooth site |
Socket Morphology | Socket morphology |
Socket Integrity | Socket integrity |
Bone Volume | Deficient horizontally, allowing simultaneous augumentation |
Anatomic Risk | Low |
Esthetic Risk | High |
Complexity | Low |
Risk of Complications | Low |
Prosthodontic SAC classification
SAC Level | Complex |
---|---|
Defining Characteristics | One missing tooth to be replaced by an implant-borne crown |
Loading Protocol | Conventional or early |
Retention | - |
Maxillomandibular Relationship | - |
Mesio-Distal Space | - |
Inter-Arch Distance | - |
Bruxism | - |
Esthetic Risk | High |
Provisional Implant-Supported Prosthesis | - |
Interim Prosthesis during Healing | - |
Occlusion/Articulation | - |
Occlusal Scheme/Issues | - |
Surgical SAC Modifiers
Periodontal Status | Healthy |
---|
Prosthodontic SAC Modifiers
Soft Tissue Contour and Volume | Significantly deficient |
---|
General SAC Modifiers
Oral Hygiene and Compliance | Good |
---|---|
Access | Adequate |
Craniofacial/Skeletal Growth | Completed |
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