Soft tissue closure over immediate implants: classification and review of surgical techniques

Despite the different opinions regarding the success of implants and guided bone regeneration membranes, with and without establishing primary wound closure at the time of surgical placement, primary closure logically seems to be the ideal surgical protocol. It prevents bacterial invasion to the wound and prevents wound disruption. In immediate implantation, lack of keratinized tissue available to achieve this surgical goal is a problem. Various surgical techniques are described to overcome this surgical difficulty, each having its advantages and drawbacks. Sound clinical judgment must be exercised when selecting a method, because it will influence the treatment result both esthetically and functionally by altering adjacent soft tissue and bony topography.