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.