Second-stage surgery in the posterior maxilla to enhance and thicken the keratinized gingiva - a case report

Bone augmentation and implant placement often lead to a coronal shift of the soft tissue. Therefore replacement of the mucogingival border during second-stage surgery is required. Different techniques have been described in the literature. In this case report a new technique for second-stage surgery from a combination of a modified roll flap, an apically repositioned split thickness flap and thick free gingival grafts between the implants will be described for predictable gain of keratinized mucosa around and between dental implants. Stable soft tissue conditions between the implants and buccal in the posterior maxilla could be gained showing almost no post-surgical resorption. With this modified technique for second-stage surgery functional and esthetic results can be achieved.