PERIO - Periodontal Practice Today
PERIO - Periodontal Practice Today 5 (2008), No. 4     4. June 2009
PERIO - Periodontal Practice Today 4 (2007), No. 4  (19.12.2007)

Page 269-275

Management of peri-implant recession associated with bone fenestration and dehiscence in the anterior region
Nikou, George / Nikolidakis, Dimitris / Thoolen, Peter / Sculean, Anton
Guided bone regeneration is a valuable treatment in order to accomplish an adequate height and thickness of alveolar bone before or during implant placement. Inadequate augmentation in combination with poor implant placement may lead to bone fenestration and/or dehiscence, which may manifest clinically as peri-implant recession. The aim of the present case report is to present the management of a recession of the peri-implant soft tissue associated with bone dehiscence and fenestration. The step-by-step procedure and the clinical outcome 18 months following treatment are presented. The treatment approach comprised reconstructive surgery by means of a natural bone mineral, bioresorbable collagen membrane and connective tissue graft followed by complete soft tissue coverage of the implant. After a period of 6 months, the second-stage surgery was performed to expose the coronal part of the implant and to place the healing abutment. The thickness of the vestibular gingiva was further increased using the modified roll technique. At 18 months following treatment, the clinical and radiographic re-evaluation revealed a stable clinical situation and a satisfactory aesthetic appearance of the peri-implant soft tissue.

Keywords: aesthetics, bone dehiscence, collagen membrane, connective tissue graft, natural bone mineral, peri-implant recession