head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing
ISSN: 1312-773X (Online)
Issue: 2017, vol. 23, issue 3
Subject Area: Dental Medicine
DOI: 10.5272/jimab.2017233.1667
Published online: 04 September 2017

Case report

J of IMAB 2017 Jul-Sep;23(3):1667-1672
Kamen Kotsilkov ORCID logo Corresponding Autoremail,
Department of Periodontology, Faculty of Dental Medicine, Medical University – Sofia, Bulgaria

INTRODUCTION: The frequent result of tooth extraction is the resorption of the buccal alveolar wall and formation of I class (Siebert) alveolar ridge defect.
Another frequent problem in the implant surgery after the elevation of the standard full thickness flap is the choice of the exact vertical implant position to provide adequate biological width with 3mm keratinized soft tissue above a bone level implant.
Nowadays the aim is to develop minimally invasive surgical approaches for other surgical applications.
AIM: This presentation demonstrates the application of a newly modified, minimally invasive, single roll flap approach for simultaneous implant placement and gingival augmentation.
MATERIALS AND METHODS: A 47 years old patient presented with fractured left central incisor. A new surgical technique for simultaneous implant placement and gingival augmentation was applied. Buccal partial thickness flap was prepared with de-epithelization and roll flap elevation of the crestal keratinized tissue, thus forming new papillae and ensuring implant placement in the exact vertical position. After one week of healing the final screw retained restoration was placed. 
RESULT: The application of this newly developed by the author modification of the surgical protocol allowed precise implant placement consistent with the biological width requirements and simultaneously achieving buccal gingival augmentation.
CONCLUSION: The proposed new surgical approach provides an opportunity for minimally invasive implant placement without periosteal elevation. The modified roll flap   preserves the keratinized tissues of the alveolar ridge using them to provide adequate buccal soft tissue volume. Furthermore, this approach ensures precise selection of the optimal implant depth, thus providing maximal functional and aesthetic result.

Keywords: single flap implant placement, modified roll flap, soft tissue oriented implant positioning,

pdf - Download FULL TEXT /PDF 2112 KB/
Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Kotsilkov K. Modified single roll flap approach for simultaneous implant placement and gingival augmentation. J of IMAB. 2017 Jul-Sep;23(3):1667-1672. DOI: 10.5272/jimab.2017233.1667

Corresponding AutorCorrespondence to: Kamen Kotsilkov, DDS, PhD – Associate Professor; Private Practice: Dental Clinic Kotsilkovi; 24 Vidini kuli str., Sofia, Bulgaria; E-mail: kamenkotsilkov@gmail.com

1. Covani U, Bortolaia C, Barone A, Sbordone L. Bucco-lingual crestal bone changes after immediate and delayed implant placement. J Periodontol. 2004 Dec;75(12):1605-12. [PubMed] [CrossRef]
2. Spray JR, Black CG, Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response: Stage 1 placement through stage 2 uncovering. Ann Periodontol. 2000 Dec;5(1):119-28. [PubMed] [CrossRef]
3. Matthews DP. The pediculated connective tissue graft: a novel approach for the "blown-out" site in the esthetic zone. Compend Contin Educ Dent. 2008 Jul-Aug;29(6):350-2, 354, 356-7. [PubMed]
4. Abrams L. Augmentation of the deformed  residual edentulous ridge for fixed prosthesis. Compend Contin Educ  Gen Dent. 1980 May-Jun;1(3):205-13. [PubMed]
5. Barone R, Clauser C, Prato GP. Localized soft tissue ridge augmentation at phase 2 implant surgery: A case report. Int J Periodontics Restorative Dent. 1999 Apr;19(2):141-5. [PubMed]
6. Park SH, Wang HL. Pouch Roll Technique for Implant Soft Tissue Augmentation: A Variation of the Modified Roll Technique. Int J Periodontics Restorative Dent. 2012 Jun;32(3):e116-21. [PubMed]
7. Mali A, Kashish, Agrawal P. Soft Tissue Ridge Augmentation Using "Roll Technique"– A Case Report. Int J Scient Res. 2016; 5(9):21-23
8. Grover D, Kaur G. Soft tissue ridge augmentation using “roll technique” – A case report. IAIM. 2014 Dec;1(4): 80-85.
9. Zucchelli G. Mucogingival Esthetic Surgery.  Quintessence Pub Co; 1 Slp Har/ edition. March 18, 2013. p.820.

Received: 20 May 2017
Published online: 04 September 2017

back to Online Journal