Title : Minimally invasive mucogingival surgery around dental implants
Abstract:
The preservation and reconstruction of peri-implant soft and hard tissues are decisive for the long-term stability and esthetic success of implant therapy. In the anterior maxilla, where esthetic demands are highest, clinicians frequently face the limitation of a thin vestibular cortical plate. The primary concern following tooth loss in the anterior maxillary region, which is regarded as an esthetically sensitive zone, is the pronounced resorption of the thin buccal cortical plate together with concomitant soft-tissue collapse. These processes frequently lead to substantial esthetic impairments. In order to mitigate such deficiencies, immediate alveolar ridge preservation and socket profile management techniques are recommended at the time of tooth extraction. The aim of this paper is to analyze minimally invasive protocols that combine hard- and soft-tissue management with immediate functional and esthetic rehabilitation. A clinical approach was applied that integrates minimally invasive mucogingival surgery with simultaneous bone augmentation in sites presenting thin vestibular cortical plates. Autogenous bone blocks harvested from the maxillary tuberosity were transplanted immediately at the time of implant placement. In selected cases, implants were restored with immediate provisional restorations, providing one-stage functional loading and esthetic integration during healing. Clinical observations demonstrated predictable compensation of vestibular bone deficiencies, improved soft-tissue volume, and stable peri-implant esthetics. The use of immediate provisionalization supported gingival architecture maintenance, facilitated patient comfort, and contributed to psychological satisfaction by avoiding edentulous periods. Patients reported reduced discomfort and accelerated recovery compared with conventional staged augmentation. Minimally invasive mucogingival and bone augmentation techniques, when combined with immediate provisional restorations, represent a biologically sound and patient-centered solution for implant placement in the anterior maxilla. This integrated approach allows simultaneous correction of vestibular bone deficiency and soft-tissue enhancement while achieving esthetic and functional rehabilitation from day one. Further prospective studies are needed to confirm long-term outcomes.
