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A simplified soft tissue management for peri-implant bone augmentation.

Leonardo Trombelli, Mattia Severi, Mattia Pramstraller

    The International Journal of Oral & Maxillofacial Implants
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    The subperiosteal peri-implant augmented layer (SPAL) technique simplifies managing peri-implant bone dehiscence and thin bone plates. This approach effectively increases hard and soft tissue dimensions around implants with minimal complications.

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    Area of Science:

    • Dental Implantology
    • Periodontology
    • Oral Surgery

    Background:

    • Peri-implant bone dehiscence and thin buccal cortical bone plates (BCBP) pose challenges in dental implantology.
    • Augmenting hard and soft tissues at the coronal portion of implants is crucial for successful outcomes.

    Purpose of the Study:

    • To illustrate a simplified surgical technique, the subperiosteal peri-implant augmented layer (SPAL), for increasing hard and soft tissue dimensions.
    • To evaluate the efficacy of the SPAL technique in managing peri-implant bone dehiscence and thin BCBP.

    Main Methods:

    • A case series involving 27 implants in 16 patients with buccal bone dehiscence or thin BCBP (< 1 mm).
    • The SPAL technique involved raising split-thickness and full-thickness flaps, grafting xenograft material, and coronally advancing the mucosal flap.
    • Implants were submerged, with re-entry procedures performed at 3-6 months for exposure.

    Main Results:

    • Uneventful healing occurred in all cases, with no signs of infection.
    • Complete resolution of bone dehiscence was observed in 80% of treated implants (12/15), with a mean subperiosteal tissue thickness (SPTT) of 3.1 ± 1.0 mm.
    • 90% of implants with thin BCBP (10/12) achieved an SPTT ≥ 2 mm at re-entry.

    Conclusions:

    • The SPAL technique is a valuable and simplified surgical approach for managing peri-implant bone dehiscence.
    • This technique effectively augments horizontal peri-implant tissue thickness with a low complication rate.