Introduction
The esthetic management and preservation of tissue stability in the area
surrounding implant abutments have been important topics for
investigation and discussion.1,2 The esthetics of
implants replacing the maxillary anterior teeth are particularly
challenging as patients are very conscious of this area, and have high
demands, especially for harmony between the implants and the soft
tissue.3-5 Soft tissue management to achieve this has
conventionally been performed after implant placement using
implant-supported provisional restorations.6
However, when this is achieved through surgical shaping and pressure
from the implant supported provisional restorations, the soft tissues
surrounding implant and other pontic areas do conform the desired shape,
but inflammation is a common complication especially in restoring
spanning multiple teeth.7,8 This inflammation has
several causes. The surgery and pressure themselves often lead to
inflammation directly, and while this management is in progress the soft
tissue and implants are not fully adapted to one another, leaving space
where food particles can be retained and plaque develop, causing further
inflammation.9 This inflammation could reduce the
stability of osseointegration, and lead to periimplantitis. This case
study demonstrates a technique for managing the soft tissue before
implant placement, which should avoid these problems. The aim of this
report is to evaluate the clinical outcome of soft tissue management
before implant placement.