When and how to correct peri implant gingiva?

Patient presented with ill-fitting existing maxillary RPD supported by 4 teeth. Remaining maxillary teeth were deemed hopeless. Treatment plan: placement of 4 implants with adequate A/P spread followed by extraction of remaining teeth following complete osseointegration of implants and fabrication of a complete overdenture with Locator attachments. Full thickness flaps were laid and implants were placed all with primary stability over 45Ncm. Healing abutments were placed on all implants and surgical areas sutured. RPD was relined with soft liner ensuring surgical areas were relieved accordingly. Roughly 2 weeks have passed since the surgery. Sutures have been removed. Patient has not experienced any pain or discomfort. Clinical exam revealed though that the peri-implant soft tissue around the posterior implants have a concavity due to what appears to be from mechanical trauma during function of the RPD. There is no implant platform exposure. Soft tissue is approximately 2-3mm in thickness. When and how would be the best approach to correcting the peri-implant soft tissue?



One thought on “When and how to correct peri implant gingiva?

  1. Matt Helm DDS says:

    The short answer to your question is yesterday! You have probably not relieved the PUD sufficiently in the implant areas, allowing it to traumatize the tissue. Your other mistake was in not burying the implants and instead placing healing caps from the beginning. Had you completely buried those implants you would not have this problem! What’s the hurry? Placing healing caps at the time of implant placement in a case like this does not in any way slow down your treatment plan. Lastly, you should have relined the PUD with a soft reliner.
    You may also need to properly instruct your patient in proper oral hygiene and ensure they follow through with it.

    (0)

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