Dr. Andres Acevedo (Venezuela)

Brief CV

• DENTIST, UNIVERSIDAD SANTA MARIA. CARACAS, VENEZUELA

• PERIODONTIST SPECIALIST, FACULDADE INGA. BAURU, BRASIL

• MASTER OF SCIENCE IN IMPLKANTOLOGY, UNIVERSIDAD SANTA MARIA. CARACAS, VENEZUELA

• ESTHETIC SPECIALIST, CENTRO UNIVERSITARIO JALES. SAO PAULO, BRASIL

• FACULTY PROFESSOR OF PERIODONTICS AND DENTAL IMPLANTS IN UNIVERSIDAD SANTA MARIA. CARACAS, VENEZUELA

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National Round

• Title : Importance of connective tissue grafting during the placement of immediate dental implants and their long-term stability. Case report

• Abstract :

  - Introduction: Tooth loss represents a significant problem for the individual affected and is also a challenge for the clinician due to the bone resorption and soft tissue recession that occur after extraction. Immediate dental implant placement is an effective treatment option, but the preservation of gingival architecture, bone stability, and long-term aesthetics are critical. The use of connective tissue grafts has been proposed as a strategy to mitigate these deficiencies.

  - Objective: This clinical case aims to illustrate and analyze the importance of using a subepithelial connective tissue graft during immediate dental implant placement, evaluating its contribution to peri-implant tissue stability and the preservation of long-term function and aesthetics.

  - Methodology: We present the case of a 63-year-old female patient who required extractions at different times and placement of a dental implant due to a root fracture. In 2017, during the first surgical act, the extraction and placement of a dental implant with bone graft but without connective tissue graft was performed. In 2021, a tissue deficiency around the implant was evident, which was successfully treated with peri-implant plastic surgery and a connective tissue graft. In 2023, the neighboring premolar suffered a fracture, and the tooth was atraumatically extracted, followed by immediate placement of a dental implant and, simultaneously, the interposition of an autologous connective tissue graft obtained from the palate. Periodic clinical and radiographic evaluations were performed to monitor peri-implant health, gingival margin stability, and bone level preservation.

  - Results: The results show excellent implant integration, notable stability of the surrounding soft tissue, and preservation of the gingival contour with no evidence of recession. Comparison of the initial clinical and follow-up photographs reveals an optimal esthetic result, with a natural appearance resembling the contralateral tooth. This suggests that the connective tissue graft played a key role in maintaining the gingival volume and margin.

  - Conclusions: Connective tissue graft placement in conjunction with immediate implant placement significantly contributes to the long-term stability of the peri-implant soft tissue and the preservation of a superior aesthetic result. This surgical approach is a predictable technique for preventing gingival recession and volume loss, resulting in an implant-supported restoration that is both functionally and aesthetically successful over the long term.