Improving Peri-implant Soft Tissue Using a Modified Rolled Connective Tissue Technique: Case Series

Achieving natural esthetics around implants in the maxilla is generally a challenge for clinicians. This is primarily due to soft and hard tissues loss that occurs post tooth extraction. In an attempt to compensate for this loss, ridge augmentation is often required before or at the time of the implant placement. In the current paper, a modification of the roll technique is described to correct soft tissue defects around implants to improve esthetics. The main modifications involve the use of a papilla preservation technique and avoidance of using sutures for the pedicle part of the connective tissue graft (CTG). The results of these clinical cases were objectively evaluated using the white esthetic score (WES) and pink esthetic score (PES). The combined score for PES and WES ranged from 16 to 20 at final follow-up (24 months) compared to 14-18 at the time of initial restoration delivery with mean scores of 9.33 +/- 0.58 for PES and 8.33 +/- 1.53 for WES. The esthetic scores of the current case series were satisfactory and remained stable at 12 and 24 months follow-up, indicating a beneficial use of the modified rolled CTG technique for improving peri-implant soft tissues.