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Clinical Case Report

Soft-Tissue Augmentation Using a Porcine-Derived Collagen Matrix to Correct a Labial Soft-Tissue Defect Following Extraction of a Maxillary Incisor

Shakeel Shahdad

In this case, Shakeel Shahdad employs a two-layer matrix to repair a soft-tissue defect in a post-extraction healed site prior to implant placement with simultaneous guided bone regeneration. This approach resulted in a gain of keratinized peri-implant mucosa with optimal shade and texture. Soft-tissue defects are often encountered prior to implant placement and may result in deficient attached keratinized mucosa, which unless corrected will yield less than ideal esthetic outcomes. The presence of keratinized mucosa has been proposed as one of the prognostic factors for the survival of dental implants (Adell and coworkers 1986) with reported greater reductions in gingival and plaque indices after increasing the width of keratinized mucosa by soft-tissue augmentation (Giannobile and coworkers 2018; Thoma and coworkers 2018).

Surgical SAC classification
Advanced
Prosthodontic SAC classification
Complex
Source
Treatment Guide 12
Purchase price
10 Academy Coins
CPD/CME
0.25 hours

Recommended content

General information

Case Type
Jaw Maxilla
Area Anterior
# of Teeth 1
# of Implants 1
Type of Implants One-Piece
Attachment One-Piece
Bone Augmentation Horizontal|Simultaneous
Augmentation Materials Autogenous chips|Xenogenous|Membrane
Guided Surgery No
Soft Tissue Grafting Staged
Abutment Type -
Prosthesis Type FDP

Esthetic Risk Assessment

Esthetic Risk Factors Low Medium High
Medical Status Healthy Compromised
Smoking Habit Non-smoker Light smoker (< 10 cigarettes per day) Heavy smoker (>= 10 cigarettes per day)
Patient's Esthetic Expectations Low Medium High
Lip Line No exposure of papillae Exposure of papillae Full exposure of mucosa margin
Periodontal Phenotype Low-scalloped, thick Medium-scalloped, medium-thick High-scalloped, thin
Shape of Tooth Crowns Rectangular Triangular
Infection at Implant Site None Chronic Acute
Bone Level at Adjacent Teeth <= 5 mm to contact point 5.5 to 6.5 mm to contact point > 7 mm to contact point
Prosthodontic Status of Neighboring Teeth Virgin Restored
Width of Edentulous Span 1 tooth (>= 7 mm) 1 tooth (< 7 mm) 2 teeth or more
Soft Tissue Anatomy Intact Defective
Bone Volume Horizontally and vertically sufficient Horizontally deficient Deficient vertically or deficient vertically AND horizontally

  • * General SAC assessment modifiers that are also part of the ERA. To avoid redundancy they are listed in this section even if no complete ERA has been made.

  • ** Not applicable to the ERA of immediate placement cases and replaced by "Socket Integrity" listed below under "Surgical SAC Classification". For all other placement types this value is a classification determinant and listed here even if no complete ERA has been made.

Surgical SAC classification

SAC Level Advanced
Defining Characteristics One missing tooth to be replaced by an implant-borne prosthesis
Modality Modality
Placement Protocol Early or late implant placement
Tooth Site Tooth site
Socket Morphology Socket morphology
Socket Integrity Socket integrity
Bone Volume Deficient horizontally, allowing simultaneous augumentation
Anatomic Risk Low
Esthetic Risk High
Complexity Low
Risk of Complications Low

Prosthodontic SAC classification

SAC Level Complex
Defining Characteristics One missing tooth to be replaced by an implant-borne crown
Loading Protocol Conventional or early
Retention -
Maxillomandibular Relationship -
Mesio-Distal Space -
Inter-Arch Distance -
Bruxism -
Esthetic Risk High
Provisional Implant-Supported Prosthesis -
Interim Prosthesis during Healing -
Occlusion/Articulation -
Occlusal Scheme/Issues -

Surgical SAC Modifiers

Periodontal Status Healthy

Prosthodontic SAC Modifiers

Soft Tissue Contour and Volume Significantly deficient

General SAC Modifiers

Oral Hygiene and Compliance Good
Access Adequate
Craniofacial/Skeletal Growth Completed
Publication date: Feb 22, 2023 Last review date: Feb 15, 2023 Next review date: Feb 15, 2026

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