A palatal roll envelope technique for peri-implant mucosa reconstruction: a prospective case series study

The aim of this study was to evaluate peri-implant soft tissue changes after performing a palatal roll envelope technique. Twelve patients, presenting a labial flat or concave profile before second-stage surgery, underwent soft tissue augmentation using the palatal roll envelope technique with papilla reservation design. The convex profile on the facial aspect, Jemt papilla index, facial mucosal level, marginal bone level, proximal bone levels of the adjacent teeth, and surgical/prosthetic complications were evaluated before surgery as the baseline, and then reevaluated at 1 week, 3 months, and 6 months after surgery. Data were analyzed using the Friedman test and Wilcoxon signed-rank test. Results indicated that the convex profile and the average papilla index score were improved, while the facial mucosal level was adjusted to a level similar to that of the contralateral tooth at 3 months and then remained stable for the follow-up visit. With the limitations identified in this report, the palatal roll envelope technique can be considered an alternative method to augment the soft tissue during second-stage surgery. This technique obviates the need for another surgical site and papillae area, and also reduces the risks of graft shrinkage and scarring on the labial site.