Dr. Ahmed ElBana

A 40-year-old healthy male presented with a peri-implant soft tissue defect characterized by a thin soft tissue phenotype and a recessed mucosal margin. Soft tissue augmentation was indicated to enhance peri-implant tissue stability and esthetics.

A provisional crown on a custom titanium abutment was fabricated with an emergence profile replicating the recessed gingival margin. This allowed controlled soft tissue conditioning and facilitated subsequent coronal repositioning of the peri-implant mucosa.

Using a minimally invasive tunneling technique, a submucosal pouch was created while preserving the vascular supply. The xenogeneic collagen matrix mucoderm^® was trimmed to the required dimensions, hydrated in sterile saline, and inserted into the prepared tunnel. A positioning suture ensured accurate placement and intimate contact with the recipient bed. The provisional crown was then installed, and a double-crossed suture technique was applied to achieve coronal stabilization of the peri-implant mucosal margin.

Two weeks postoperatively, uneventful healing and a favorable early soft tissue response were observed. At the one-year follow-up, successful peri-implant soft tissue phenotype modification was evident, with increased tissue thickness and a stable, well-contoured mucosal margin supporting long-term peri-implant health and esthetics.