Buccal bone exostosis (BBE) is a late postoperative complication following soft tissue augmentations (STA), defined as localized peripheral benign bone overgrowth. While its occurrence has been reported after skin or free gingival grafts, its association with sub epithelial connective tissue grafts (sCTG) around teeth is less documented. To date, no cases of BBE following autologous tissue grafts, sCTG or de-epithelialized free gingiva grafts (DFGG), around dental implants have been reported. This case series presented five cases of BBE (two around implants, three around teeth) following STA around teeth and implants utilizing either sCTG or DFGG. The BBEs were surgically removed in three cases, and no recurrences were observed after four months to ten years postoperatively. Histological examinations were not conducted. Based on the fact that all cases involved partial-thickness flap, it could be speculated that periosteal tear during STA coupled with autologous tissue grafts triggers osteoinduction and osteoproliferation mechanisms, leading to BBE development.
Keywords: buccal bone exostosis, implants, connective tissue graft, deepithelialized free gingival graft, postoperative complications, periodontal surgery, case series
