Abstract:
Introduction. Mucogingival surgery in the case of keratinized soft tissue deficiency is indicated to optimize
the volume of the peri-implant soft tissue to reduce the risk of further complications (peri-implantitis,
mucositis, peri-implant recession). A number of surgical methods for peri-implant soft tissue management
are proposed, which makes it difficult to choose the optimal one for specific clinical situations.
Aim of the study. Evaluation of surgical methods for peri-implant soft tissue management.
Methods and materials. Clinical case presentation, patient F / 39 year old was rehabilitated with an
implant-prosthetic in the dental clinic "Omni Dent" in the period 2021-2022. The patient had a deficiency
of width of the keratinized soft tissue (LGK) as well as the thickness of the keratinized soft tissue (GGK).
The stage of mucogingival surgery was decided to be performed after implant osseointegration. At the stage
of uncovering the implants 14, 15, 24, 36, 3 mucogingival surgical methods were used: 1) at the level of
the implants 14, 15 the apical positioned flap technique; 2) at the level of the implant 25 the pouch roll
technique; 3) at the level of the implant 36, the free gingival graft from the palate. Study criteria: keratinized
soft tissue width, thickness, trauma morbidity, complications. Dynamic monitoring 2-14 days, one month
and 3 months - postoperatively.
Results. The patient was monitored postoperatively in dynamics to evaluate 3 methods performed
simultaneously comparing them according to the proposed criteria. Method 1: preoperative LGK - 3 mm,
postoperative LGK - 6 mm; GGK pre- 1.5 mm, GGK post- 3 mm; moderate edema; moderate pain; difficult
and long time to perform. Method 2 LGK pre- 4 mm, LGK post- 7 mm; GGK pre-2 mm, GGK post-4 mm;
edema, insignificant pain; simple and short time to perform. Method 3 LGK pre- 3 mm, LGK post- 8 mm;
GGK pre-2 mm, GGK post-4 mm; moderate edema; moderate pain in the donor and recipient area; difficult
and long time to perform. Postoperative complications were not present. The choice of methods used in the
study should be based on the analysis of several criteria and individualized to the clinical case despite the
advantages and disadvantages.
Conclusion. The technique of rotating flap (method 2) proved to be the method with the best results
according to the established criteria, being followed by the technique of free gingival grafting from the
palate (method 3), a good result but with more sacrifice. The last method with the apical positioned flap
(method 1) did not show high efficiency obtaining minimum thickness difficult work and long time to
perform, it is a method that requires a higher training and precision to perform.
