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Split pedicle roll envelope technique around implants and pontics: a prospective case series study.

Y Man1, Q Wu1, T Wang1

  • 1State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.

International Journal of Oral and Maxillofacial Surgery
|June 11, 2015
PubMed
Summary

A novel split pedicle roll envelope technique effectively restored gingival contour in patients with missing anterior maxillary teeth. This method improved soft tissue profiles and papilla levels for enhanced aesthetics.

Keywords:
dental aestheticsdental papillaimplant-supported dental prosthesispedicled flappontic

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Area of Science:

  • Dental Implantology
  • Periodontology
  • Aesthetic Dentistry

Background:

  • Restoring harmonious gingival contours for missing anterior maxillary teeth presents significant challenges.
  • Deficiencies in labial soft tissue profiles at implant and pontic sites often compromise aesthetic outcomes.

Purpose of the Study:

  • To evaluate a split pedicle roll envelope technique for pontics in managing gingival contour deficiencies.
  • To assess the efficacy of this technique in improving soft tissue parameters and aesthetic results.

Main Methods:

  • Twelve patients with labial concavity underwent a palatal split pedicle flap procedure, with parts rolled into labial and pontic envelopes.
  • Interim restorations guided tissue remodeling, and measurements of labial convex profile (CPF), facial mucosal level (FML), Jemt papilla index (PIS), and bone levels were taken.
  • Data collection occurred at baseline and at 1 week, 3 months, and 6 months post-surgery.

Main Results:

  • Significant increases in CPF (1.4mm implant, 1.5mm pontic site) and PIS (2.0 implant-tooth/pontic-tooth, 2.6 implant-pontic) were observed at 6 months.
  • Facial mucosal levels were coordinated with contralateral teeth, and all measured indices showed favorable results by 3 months, remaining stable thereafter.
  • Peri-implant bone levels were also monitored throughout the study period.

Conclusions:

  • The split pedicle roll envelope technique, combined with interim restorations, offers a viable solution for aesthetic challenges in cases of missing contiguous maxillary anterior teeth.
  • This approach can successfully recreate harmonious gingival contours and improve soft tissue aesthetics, contributing to overall treatment success.