Surgical flap options for dental implants

Surgical flaps around dental implants are important if you hope to maintain natural looking tissue and papilla.

The modified dental implant surgical flap.

This flap can help form form a papilla between two dental implants.

Side by side implant uncovering

Side by side dental implants

However, this flap design from Zhang JPD 2022 is likely even better.

The esthetic buccal flap or aesthetic buccal flap for you fancy people.

Steigmann has most of the literature on this flap. It is the same flap one uses for apicoectomies. You can use this flap to treat a fenestration when doing an immediate dental implant or just doing some bone grafting post extraction. So for your buccal fenestrations, use an aesthetic buccal flap (ABF).

Palacci Flap

This flap removes some of the facial or buccal connective tissue and puts it in an area that will fill in with connective tissue. Seems that in most cases will do more harm than good. However, in the anterior may be beneficial to help get more of a papilla.

Guided gingival growth to increase keratinized tissue

Basically just using a healing abutment that isn’t quiet tall enough for it to stick all the way out. A 2-3mm tall healing abutment is often ideal. An incision is made to uncover implant, healing abutment is placed, and tissue is sutured up and over. Tissue heals almost over and 4 weeks later a new taller abutment is placed pushing all the extra tissue to the buccal.

For teeth that need a dental implant and have little keratinized tissue to start with one can use this method pre-extraction to gain tissue.

Source of this information can be found in dentistry today

 Other techniques

Other techniques to alter the connective tissue can occur before implant placement by allowing extraction socket to heal in.