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Simplified SPAL technique to provide adequate peri-implant phenotype: A pilot study
Leonardo Trombelli1,2, Chiara Franzini1,2, Mattia Severi1,2
1Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.
Clinical Advances in Periodontics
|August 11, 2026
Summary
The simplified subperiosteal peri-implant augmented layer (sSPAL) technique effectively corrects peri-implant bone dehiscence and enhances soft tissue. This one-stage approach offers a valuable alternative for improving peri-implant tissue stability.
Area of Science:
- Dental Implantology
- Periodontology
- Oral Surgery
Background:
- Peri-implant bone dehiscence (PIBD) and soft tissue phenotype are crucial for long-term implant stability.
- A simplified, one-stage technique (sSPAL) was evaluated for PIBD correction and soft tissue optimization.
Purpose of the Study:
- To assess the efficacy of the simplified subperiosteal peri-implant augmented layer (sSPAL) technique.
- To evaluate the management of both hard and soft peri-implant tissues in a single intervention.
Main Methods:
- Eight patients with posterior mandibular edentulous sites and PIBD received implants with sSPAL.
- Clinical and radiographic parameters were assessed at 12 months, including bone dehiscence, bone thickness, and soft tissue dimensions.
Main Results:
- Complete resolution of PIBDs and a buccal bone thickness (BBT) of ≥1.5 mm were observed in all patients at 12 months.
- All implants showed adequate keratinized mucosa height (≥2 mm), stable soft tissues, and minimal probing depths.
Conclusions:
- The sSPAL technique is a feasible approach for reconstructing hard tissue and augmenting soft tissue around implants.
- sSPAL offers a simplified, valuable alternative to the conventional two-stage SPAL technique for managing peri-implant defects.