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Dr. Palombo graduated in dentistry from the University of Milan in 2015, with a concentration in oral surgery (Head Prof. Matteo Chiapasco). In 2017, he won the International Research Fellowship of the Italian Society of Osseointegration and obtained a Master of Sciences (MSc) from the Complutense University in Madrid. Then, he completed a post-graduate program in periodontal plastic surgery at the University of Bologna (Head Prof. Giovanni Zucchelli) and is now enrolled in the 3 year full-time master in periodontics and implant dentistry at the Complutense University in Madrid (Head Prof. Mariano Sanz), certified by the European Federation of Periodontology.
The management of severe mucogingival deformities surrounding malpositioned implants represents a complex issue with a high risk of aesthetic failure. The present case report describes a mucogingival and restorative approach for the treatment of severe localized peri-implant tissue deficiencies with interproximal bone loss combined with an interproximal gingival recession on the adjacent natural tooth. This consists of maintaining a non-restorable malpositioned implant, submerging it through one or multiple vertical soft tissue augmentations, according to the defect severity, and delivering a tooth supported bridge involving the adjacent natural teeth. The step-by-step surgical technique adopted for implant submergence and vertical soft tissue grafting, as well as the subsequent surgical and prosthetic interventions, are described, presenting results at 5 years from implant submergence and 3 years from prosthetic finalization.
Keywords: Implants, Periodontal Surgery, Prosthetic Dentistry, Gingival Recession, Mucogingival Surgery, Dental Implant, Case Report
A simplified surgical technique is presented for closure and soft tissue augmentation of fresh extraction sockets that utilizes a xenogeneic collagen matrix as a substitute for a combined onlay-interpositional connective tissue graft. Ten alveoli receiving a socket preservation procedure (n = 5) or an immediate submerged implant (n = 5) were sealed with a xenogeneic collagen matrix, stabilized under small palatal and buccal full-thickness envelope flaps. Eight weeks after surgery, full wound closure was achieved in 9 out of 10 sites with satisfactory esthetic integration (mean ΔE score: 3.76). Results from this descriptive observational study suggest that this technique may represent a valuable and minimally invasive solution to simplify closure and soft tissue augmentation of fresh extraction sockets.