Wound dehiscence after implant placement: potential causes?

Any grafting or membranes used ? what sutures were used ? the pain may be an issue ...... what torque did you use ?? Sorry more questions at the moment Peter

Great pain receded , now watch for full closure , if not use healing caps and ensure site is kept clean . Just starting some research into healing by secondary intention over graft sites ........ hope all goes well , monitor . Peter

I hope for the same . great your line of research sounds pretty interesting and I think would involve a lot of histopathology. All the best with that. Will keep you updated about my case . also henceforth I will try and back up my cases with good photographs

Without intraoral pictures/ CT or Radiographs no real way to tell you what occurred. Mostly likely too much tension in your flap as you say. You mentioned lack of attached tissue so that's my bet. In the future look to prepare the site to obtain more attached tissue. Site preparation is the key to success often times. Try to get 3mm of attached tisse on the buccal aspect of that implant minimally. if not attempting a ct graft you can make your crestal incision 3mm lingual or palatal from the midline of your ridge then just apically position that flap after your implant placement. Use of alloderm works in the right hands also. Consider not doing a continuous suture or interrupted and place interrupted mattress suture. You will get more "tissue grab" with the mattress with far less tension. My personal preference for sutures is the PTFE by Cytoplast. These have been shown to wick the least amount of bacteria and are very easy to tie without too tissue tension or trauma.

Thank you sir. I completely agree with you about the suture material and the technique suggested by you. However having 3 mm of attached gingiva is no gold standard (would be a blessing to have it) its absolutely alright to carry out a surgical procedure when 1. The tissue does not move while the patient is performing the daily movements and 2. If the patient is able to maintain oral hygiene. Also instead of going lingual to the crest its better to give a distant incision buccally in the vestibule. Just my opinion.

Sir I did understand your point.. Basically you are referring to an apically displaced flap which would help to create some amount of attached gingiva . But I was suggesting another approach which would involve an incision in the buccal vestibule (distant incision from the site) . I really appreciate you giving in your time and suggestions. Also let me see if I can post the cbct and the iopa of this particular case. Regards