Tissue Graft Prevents Gum Recession After Tooth Implant

When a tooth is replaced with an im­plant, gingival recession can be­come a concern. This leaves areas of root ex­posed and can be painful for the pa­tient. While a single tooth replacement performed as an immediate, one-step process is an accepted treatment, gingival recession occurs more often with this method of implant.

The Journal of Oral Im­plantology reports on a case series of 10 patients who received a single immediate tooth re­placement in conjunction with sub­epithelial connective tissue graft. The tissue graft has proven successful in making gingival tissue more resistant to recession. In the im­mediate tooth replacement procedure, a failing tooth is removed and an implant is immediately placed into the socket. For the tissue graft, tissue is harvested from the palate using a single incision. The graft material is in­serted into a prepared space be­tween the labial bony plate and the gingiva of the extraction site. The graft preserves soft-tissue levels, making the gingiva less likely to recede. Marginal bone level is another way to gauge the success of an im­plant. A more recent suggestion, which this study evaluates, is that this bone level can be influenced by the way the implant and abutment connect. "Plat­form switching"—which refers to the size discrepancy between these 2 components—can be beneficial in maintaining the marginal bone level. In this study, patients were evaluated before surgery, at the time of tooth replacement, and at 3, 6, and 12 months after surgery. One implant failed early in the process, but at one year the remaining 9 patients showed good integration of tissue and tooth with minimal loss of marginal bone level or facial gingival level. The authors concluded that with proper implant position and the placement of graft material, a favorable success rate can be achieved.


(Source: Journal of Oral Implantology. 2011, Volume 37, Number 5)