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Reconstructive Peri-Implantitis Surgery Using an Internally Beveled Vestibular Incision for Multilayer Wound Closure.

Erdem Gülnergiz1, Sophia M Abraha1,2, Markus Hürzeler1,3

  • 1Private Practice Hürzeler/Zuhr, Munich, Germany.

Journal of Esthetic and Restorative Dentistry : Official Publication of the American Academy of Esthetic Dentistry ... [Et Al.]
|February 19, 2026
PubMed
Summary
This summary is machine-generated.

A modified surgical technique using an internally beveled vestibular incision and multilayer suturing promotes primary wound healing after reconstructive peri-implantitis surgery, leading to improved outcomes.

Keywords:
beveled vestibular incisionbone reconstructionmultilayer wound closureperi‐implant mucosal recessionreconstructive surgical therapy of peri‐implantitis

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Area of Science:

  • Dental implantology
  • Periodontology
  • Oral surgery

Background:

  • Peri-implantitis surgery outcomes depend on complication-free healing, particularly primary intention healing.
  • Peri-implant tissues have compromised wound healing capacity compared to periodontal tissues due to biological differences.
  • Tunneling flap techniques and vestibular access flaps can preserve critical interproximal soft tissues.

Purpose of the Study:

  • To present a modified surgical approach for reconstructive peri-implantitis surgery.
  • To improve predictable primary wound healing and reconstructive outcomes.
  • To preserve peri-implant papillary integrity.

Main Methods:

  • An internally beveled vestibular incision in the alveolar mucosa was utilized.
  • Flap preparation, implant surface decontamination, and defect reconstruction with autogenous tuberosity bone were performed.
  • A four-layer closure technique was employed, incorporating an additional tissue wedge for enhanced flap margin stability.

Main Results:

  • The modified approach achieved primary wound healing in all treated cases.
  • Substantial reconstructive outcomes were observed at the 1-year follow-up.
  • The technique facilitated wound stabilization within the alveolar mucosa.

Conclusions:

  • Preserving peri-implant papillary integrity via an internally beveled vestibular incision and multilayer suturing aids predictable primary intention healing.
  • This technique is beneficial for reconstructive peri-implantitis surgery, especially in esthetic zones.
  • The modified approach offers a viable strategy for managing peri-implantitis defects.