A new technique to combine barrier removal at dehisced implant sites with a plastic periodontal procedure

Three case reports are used to describe a new surgical technique that permits the combination of barrier removal and an apically repositioning flap procedure at implant exposure surgery of previously dehisced or fenestrated implant sites. The flap procedure allows the creation of an adequate zone of keratinized mucosa. In contrast to existing techniques, this method eliminates bone denudation on the interproximal and oral aspect by means of a split-thickness flap surgery. Advantages of this procedure are optimal protection of the bone and reduction of postsurgical discomfort by minimizing the possibility of infection and resorption processes on the bone surface. Furthermore, flap management and fixation are facilitated. Although the necessity of keratinized mucosa around implants i controversial, its presence is favorable in cases where esthetics is important.