Pinwheel Pedicle Flap Technique for Increasing Keratinized Tissue at Stage 2 Implant Surgery

The goal of stage 2 implant surgery is to uncover implants while maintaining or augmenting the peri-implant keratinized tissue. Although the absolute requirement for keratinized tissue around natural teeth can be debated, implants appear to have consistently improved postoperative clinical parameters and health when there is an adequate keratinized peri-implant tissue.

This article presents a new technique to optimize the keratinized tissue around implants during stage 2 surgery. Although there are many treatment options that can be considered at the time of surgery, the technique presented here has the advantage of increasing the keratinized tissue circumferentially around the implant without using a second donor site. The technique, called the "pinwheel," is presented in two cases with the same clinical presentation. Two mandibular overdenture patients with ≤3 mm of keratinized tissue over implant sites, stage 2 surgery was performed using the "pinwheel technique" to increase the keratinized tissue on the facial and lingual surfaces.

The use of the pinwheel technique to augment keratinized tissue around implants is effective and is a viable treatment option during stage 2 implant surgery.