Punch technique for preservation of interdental papillae at nonsubmerged implant placement

Surgical flap procedures currently used for the placement of endosseous implants often can result in damage to the interdental papilla with subsequent poor esthetics. A simple technique is presented whereby the implants are placed by using a tissue punch and without raising a full thickness flap. At no time is the subperiosteal soft tissue flap raised, and the integrity of the interdental papilla is never disrupted. There is no discontinuation of the alveolar blood supply of the surrounding osseous tissue. In the authors' experience, there has been a significant reduction in postoperative discomfort. It is proposed that this technique warrants further evaluation, especially to compare the rate of bone resorption, because it is hypothesized that because of lack of discontinuation of the blood supply, there might be reduced bone resorption compared with conventional flap procedures.