Esthetic treatment of alveolar ridge atrophy in the anterior maxilla via connective tissue graft performed simultaneously with implant placement: A three-case series

Objective: The mere osseointegration of an implant should no longer be considered a satisfactory criterion for success. Tooth extraction itself and, more importantly, possible local comorbidities such as periodontal or endodontic diseases, cause a reduction in the gingival volume of the edentulous site due to bone atrophy. This reduced volume must be treated and resolved to obtain a satisfactory esthetic result, which is an essential factor for successful implant rehabilitation. The classic approach to this problem relies on bone augmentation procedures. However, the present clinical study is aimed at showing that insufficient gingival volume may be corrected simply by resorting to soft tissue augmentation, provided that sufficient bone is present to allow implant placement. Clinical Considerations: The treatment is described of three cases characterized by considerable ridge atrophy that was caused by a simple extraction in the first case, periodontal breakdown in the second case, and radicular cyst removal in the third case. After healing, all cases presented with sufficient bone to allow implant placement, and insufficient volume was treated via soft tissue grafts during implant surgery. Esthetic results and patient satisfaction were monitored for 2 to 4 years and were very encouraging. Conclusion: Although the approach described in this report requires further investigation, it will likely lead to good results when used to treat a lack of pink volume in the most important esthetic area. Keywords: connective tissue graft, esthetic treatment, implant, implant treatment, ridge atrophy