Mandibular Rotated Pediculated Flap: A Technique to Increase Peri-Implant Mucosa Thickness

Peri-implant soft tissue is considered critical for maintaining peri-implant health, minimizing esthetic and biological complications, and promoting the long-term stability of implant-supported restorations. This article describes a straightforward and minimally invasive technique for augmenting the peri-implant mucosa thickness (MT) in the mandibular posterior area using a rotated pedicled flap (MRPF).

The described surgical procedure was conducted on sixteen systemically healthy adults (8 males, 8 females) with posterior mandibular partial edentulism and a thin tissue phenotype. Periodontal plastic surgery was performed at the second stage of implant surgery using a rotated pedicled mucoperiosteal flap (MRPF) obtained from the adjacent distal mandibular retromolar area. Clinical and digital analysis variables demonstrated a peri-implant mucosal thickness increase (2.72 ± 0.69 mm) at 12 months follow-up after the definitive implant-supported restoration delivery.

Despite the limitations of this study, the proposed surgical technique successfully increased the buccal peri-implant MT. However, further randomized controlled studies are required to assess the efficacy of MRPF.

The quality and quantity of peri-implant mucosa are considered to have a potential impact on maintaining peri-implant health. MRPF may increase peri-implant MT in the mandibular posterior area. Notably, no additional donor site is required for this procedure, leading to a potential reduction in patient morbidity.