A method to gain keratinized tissue pre-implant surgery

The first question to ask is do you need more keratinized tissue? How much are you starting with?

There are different methods to use depending on if a tooth is still in place or not.

Many premolars and canines lack much keratinized tissue and may benefit from this procedure.  Would be good when have such a tooth that fractures at gumline.  Some of these teeth may be considered for PET.  If the tooth fractures to below gumline during attempt to luxate for PET then go to this technique.

Steps

1. Remove tooth structure to slightly below bone level
2. Have patient use CHX in area for three weeks
3. Area will fill in with keratinized tissue
4. Guided surgery with tooth root in place
5. Remove remaining tooth or leave some for socket shield technique
6. Place implant with apically re-positioned flap

Reference  Immediate Implant Placement with a Novel Approach to get Adequate Soft Tissue Coverage: A Case Report

There are lots of methods to gain tissue after implant placement as well.