Dr. Stuardo Valenzuela Manfredi

Clinical Situation:

In this clinical case, a patient presented with a missing tooth in the posterior mandible (tooth 46), characterized by a deficiency in buccal soft tissue contour and a thin mucosal phenotype. The treatment objective was to restore soft tissue volume and improve the peri-implant contour to support a stable and aesthetic restorative outcome.

Implant placement was performed using a prosthetically driven approach with a tissue-level implant. To compensate for the deficient soft tissue volume, a native dermis collagen matrix, mucoderm^®, was applied at the buccal aspect to achieve both horizontal and vertical soft tissue thickening.
A 3-mm healing abutment was placed, and primary wound closure was achieved with sutures without exposure of the collagen matrix.

Healing progressed uneventfully. At the 3-month follow-up, clinical examination demonstrated successful integration of the collagen matrix, with a noticeable increase in soft tissue thickness and an improved buccal contour. The enhanced peri-implant soft tissue architecture provided favorable conditions for definitive prosthetic rehabilitation.

The final restoration consisted of a screw-retained monolithic lithium disilicate crown. At the 1-year follow-up, further improvement in peri-implant soft tissue thickness was observed compared with the day of crown placement. Remarkably, the 5-year follow-up demonstrated an additional increase in soft tissue volume and stable peri-implant conditions, confirming the long-term maintenance of the augmented tissue contour.

This case demonstrates the predictable performance of mucoderm^® for simultaneous horizontal and vertical soft tissue augmentation around implants, providing progressive soft tissue thickening and stable peri-implant contours over a 5-year follow-up period.