A simple approach to preserve keratinized mucosa around implants using a pre-fabricated implant-retained stent: a report of two cases
Identifieur interne : 001F12 ( Pmc/Curation ); précédent : 001F11; suivant : 001F13A simple approach to preserve keratinized mucosa around implants using a pre-fabricated implant-retained stent: a report of two cases
Auteurs : Jung-Chul Park [Corée du Sud] ; Ki-Bin Yang [Corée du Sud] ; Youna Choi [Corée du Sud] ; Yong-Tae Kim [Corée du Sud] ; Ui-Won Jung [Corée du Sud] ; Chang-Sung Kim [Corée du Sud] ; Kyoo-Sung Cho [Corée du Sud] ; Jung-Kiu Chai [Corée du Sud] ; Chong-Kwan Kim [Corée du Sud] ; Seong-Ho Choi [Corée du Sud]Source :
- Journal of Periodontal & Implant Science [ 2093-2278 ] ; 2010.
Abstract
There is no consensus regarding the relationship between the width of keratinized mucosa and the health of peri-implant tissues, but clinicians prefer to provide enough keratinized mucosa around dental implants for long-term implant maintenance. An apically positioned flap during second stage implant surgery is the chosen method of widening the keratinized zone in simple procedures. However, the routine suture techniques used with this method tend to apply tension over the provisional abutments and decrease pre-existing keratinized mucosa. To overcome this shortcoming, a pre-fabricated implant-retained stent was designed to apply vertical pressure on the labial flap and stabilize it in a bucco-apical direction to create a wide keratinized mucous zone.
During second stage implant surgery, an apically displaced, partial thickness flap with a lingualized incision was retracted. A pre-fabricated stent was clipped over the abutments after connecting to the provisional abutment. Vertical pressure was applied to displace the labial flap. No suture was required and the stent was removed after 10 days.
A clinically relevant amount of keratinized mucosa was achieved around the dental implants. Buccally displaced keratinized mucosa was firmly attached to the underlying periosteum. A slight shrinkage of the keratinized zone was noted after the healing period in one patient, but no discomfort during oral hygiene was reported. Clinically healthy gingiva with enough keratinized mucosa was achieved in both patients.
The proposed technique is a simple and time-effective technique for preserving and providing keratinized tissue around dental implants
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DOI: 10.5051/jpis.2010.40.4.194
PubMed: 20827329
PubMed Central: 2931308
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A simple approach to preserve keratinized mucosa around implants using a pre-fabricated implant-retained stent: a report of two cases</title><author><name sortKey="Park, Jung Chul" sort="Park, Jung Chul" uniqKey="Park J" first="Jung-Chul" last="Park">Jung-Chul Park</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Yang, Ki Bin" sort="Yang, Ki Bin" uniqKey="Yang K" first="Ki-Bin" last="Yang">Ki-Bin Yang</name><affiliation wicri:level="1"><nlm:aff id="A2">Goodmorning Dental Clinic, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Goodmorning Dental Clinic, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Choi, Youna" sort="Choi, Youna" uniqKey="Choi Y" first="Youna" last="Choi">Youna Choi</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Yong Tae" sort="Kim, Yong Tae" uniqKey="Kim Y" first="Yong-Tae" last="Kim">Yong-Tae Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Jung, Ui Won" sort="Jung, Ui Won" uniqKey="Jung U" first="Ui-Won" last="Jung">Ui-Won Jung</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Chang Sung" sort="Kim, Chang Sung" uniqKey="Kim C" first="Chang-Sung" last="Kim">Chang-Sung Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Cho, Kyoo Sung" sort="Cho, Kyoo Sung" uniqKey="Cho K" first="Kyoo-Sung" last="Cho">Kyoo-Sung Cho</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Chai, Jung Kiu" sort="Chai, Jung Kiu" uniqKey="Chai J" first="Jung-Kiu" last="Chai">Jung-Kiu Chai</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Chong Kwan" sort="Kim, Chong Kwan" uniqKey="Kim C" first="Chong-Kwan" last="Kim">Chong-Kwan Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Choi, Seong Ho" sort="Choi, Seong Ho" uniqKey="Choi S" first="Seong-Ho" last="Choi">Seong-Ho Choi</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">20827329</idno><idno type="pmc">2931308</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931308</idno><idno type="RBID">PMC:2931308</idno><idno type="doi">10.5051/jpis.2010.40.4.194</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">001F12</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001F12</idno><idno type="wicri:Area/Pmc/Curation">001F12</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001F12</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A simple approach to preserve keratinized mucosa around implants using a pre-fabricated implant-retained stent: a report of two cases</title><author><name sortKey="Park, Jung Chul" sort="Park, Jung Chul" uniqKey="Park J" first="Jung-Chul" last="Park">Jung-Chul Park</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Yang, Ki Bin" sort="Yang, Ki Bin" uniqKey="Yang K" first="Ki-Bin" last="Yang">Ki-Bin Yang</name><affiliation wicri:level="1"><nlm:aff id="A2">Goodmorning Dental Clinic, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Goodmorning Dental Clinic, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Choi, Youna" sort="Choi, Youna" uniqKey="Choi Y" first="Youna" last="Choi">Youna Choi</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Yong Tae" sort="Kim, Yong Tae" uniqKey="Kim Y" first="Yong-Tae" last="Kim">Yong-Tae Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Jung, Ui Won" sort="Jung, Ui Won" uniqKey="Jung U" first="Ui-Won" last="Jung">Ui-Won Jung</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Chang Sung" sort="Kim, Chang Sung" uniqKey="Kim C" first="Chang-Sung" last="Kim">Chang-Sung Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Cho, Kyoo Sung" sort="Cho, Kyoo Sung" uniqKey="Cho K" first="Kyoo-Sung" last="Cho">Kyoo-Sung Cho</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Chai, Jung Kiu" sort="Chai, Jung Kiu" uniqKey="Chai J" first="Jung-Kiu" last="Chai">Jung-Kiu Chai</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Chong Kwan" sort="Kim, Chong Kwan" uniqKey="Kim C" first="Chong-Kwan" last="Kim">Chong-Kwan Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Choi, Seong Ho" sort="Choi, Seong Ho" uniqKey="Choi S" first="Seong-Ho" last="Choi">Seong-Ho Choi</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Periodontal & Implant Science</title><idno type="ISSN">2093-2278</idno><idno type="eISSN">2093-2286</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>There is no consensus regarding the relationship between the width of keratinized mucosa and the health of peri-implant tissues, but clinicians prefer to provide enough keratinized mucosa around dental implants for long-term implant maintenance. An apically positioned flap during second stage implant surgery is the chosen method of widening the keratinized zone in simple procedures. However, the routine suture techniques used with this method tend to apply tension over the provisional abutments and decrease pre-existing keratinized mucosa. To overcome this shortcoming, a pre-fabricated implant-retained stent was designed to apply vertical pressure on the labial flap and stabilize it in a bucco-apical direction to create a wide keratinized mucous zone.</p></sec><sec><title>Methods</title><p>During second stage implant surgery, an apically displaced, partial thickness flap with a lingualized incision was retracted. A pre-fabricated stent was clipped over the abutments after connecting to the provisional abutment. Vertical pressure was applied to displace the labial flap. No suture was required and the stent was removed after 10 days.</p></sec><sec><title>Results</title><p>A clinically relevant amount of keratinized mucosa was achieved around the dental implants. Buccally displaced keratinized mucosa was firmly attached to the underlying periosteum. A slight shrinkage of the keratinized zone was noted after the healing period in one patient, but no discomfort during oral hygiene was reported. Clinically healthy gingiva with enough keratinized mucosa was achieved in both patients.</p></sec><sec><title>Conclusions</title><p>The proposed technique is a simple and time-effective technique for preserving and providing keratinized tissue around dental implants</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Adell, R" uniqKey="Adell R">R Adell</name></author><author><name sortKey="Lekholm, U" uniqKey="Lekholm U">U Lekholm</name></author><author><name sortKey="Rockler, B" uniqKey="Rockler B">B Rockler</name></author><author><name sortKey="Branemark, Pi" uniqKey="Branemark P">PI Branemark</name></author><author><name sortKey="Lindhe, J" uniqKey="Lindhe J">J Lindhe</name></author><author><name sortKey="Eriksson, B" uniqKey="Eriksson B">B Eriksson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lekholm, U" uniqKey="Lekholm U">U Lekholm</name></author><author><name sortKey="Adell, R" 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Kahnberg</name></author><author><name sortKey="Albrektsson, T" uniqKey="Albrektsson T">T Albrektsson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Brygider, Rm" uniqKey="Brygider R">RM Brygider</name></author><author><name sortKey="Bain, Ca" uniqKey="Bain C">CA Bain</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Periodontal Implant Sci</journal-id><journal-id journal-id-type="publisher-id">JPIS</journal-id><journal-title-group><journal-title>Journal of Periodontal & Implant Science</journal-title></journal-title-group><issn pub-type="ppub">2093-2278</issn><issn pub-type="epub">2093-2286</issn><publisher><publisher-name>Korean Academy of Periodontology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">20827329</article-id><article-id pub-id-type="pmc">2931308</article-id><article-id pub-id-type="doi">10.5051/jpis.2010.40.4.194</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>A simple approach to preserve keratinized mucosa around implants using a pre-fabricated implant-retained stent: a report of two cases</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Park</surname><given-names>Jung-Chul</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Yang</surname><given-names>Ki-Bin</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Choi</surname><given-names>Youna</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Yong-Tae</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Jung</surname><given-names>Ui-Won</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Chang-Sung</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Cho</surname><given-names>Kyoo-Sung</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Chai</surname><given-names>Jung-Kiu</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Chong-Kwan</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Choi</surname><given-names>Seong-Ho</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</aff><aff id="A2"><label>2</label>Goodmorning Dental Clinic, Seoul, Korea.</aff><author-notes><corresp>Correspondence: Seong-Ho Choi. Department of Periodontology, Yonsei University College of Dentistry, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea. <email>shchoi726@yuhs.ac</email>, Tel: +82-2-2228-3189, Fax: +82-2-392-0398</corresp></author-notes><pub-date pub-type="ppub"><month>8</month><year>2010</year></pub-date><pub-date pub-type="epub"><day>30</day><month>8</month><year>2010</year></pub-date><volume>40</volume><issue>4</issue><fpage>194</fpage><lpage>200</lpage><history><date date-type="received"><day>27</day><month>5</month><year>2010</year></date><date date-type="accepted"><day>20</day><month>7</month><year>2010</year></date></history><permissions><copyright-statement>Copyright © 2010 Korean Academy of Periodontology</copyright-statement><copyright-year>2010</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>).</license-p></license></permissions><abstract><sec><title>Purpose</title><p>There is no consensus regarding the relationship between the width of keratinized mucosa and the health of peri-implant tissues, but clinicians prefer to provide enough keratinized mucosa around dental implants for long-term implant maintenance. An apically positioned flap during second stage implant surgery is the chosen method of widening the keratinized zone in simple procedures. However, the routine suture techniques used with this method tend to apply tension over the provisional abutments and decrease pre-existing keratinized mucosa. To overcome this shortcoming, a pre-fabricated implant-retained stent was designed to apply vertical pressure on the labial flap and stabilize it in a bucco-apical direction to create a wide keratinized mucous zone.</p></sec><sec><title>Methods</title><p>During second stage implant surgery, an apically displaced, partial thickness flap with a lingualized incision was retracted. A pre-fabricated stent was clipped over the abutments after connecting to the provisional abutment. Vertical pressure was applied to displace the labial flap. No suture was required and the stent was removed after 10 days.</p></sec><sec><title>Results</title><p>A clinically relevant amount of keratinized mucosa was achieved around the dental implants. Buccally displaced keratinized mucosa was firmly attached to the underlying periosteum. A slight shrinkage of the keratinized zone was noted after the healing period in one patient, but no discomfort during oral hygiene was reported. Clinically healthy gingiva with enough keratinized mucosa was achieved in both patients.</p></sec><sec><title>Conclusions</title><p>The proposed technique is a simple and time-effective technique for preserving and providing keratinized tissue around dental implants</p></sec></abstract><kwd-group><kwd>Dental esthetics</kwd><kwd>Dental implants</kwd><kwd>Gingiva</kwd></kwd-group></article-meta></front><floats-group><fig id="F1" position="float"><label>Figure 1</label><caption><p>Radiographic photo after first stage implant surgery.</p></caption><graphic xlink:href="jpis-40-194-g001"></graphic></fig><fig id="F2" position="float"><label>Figure 2</label><caption><p>Clinical photo taken 4 months post-implantation. There was a decreased keratinized mucous zone and the buccal side of #31 was partially covered with mucosa.</p></caption><graphic xlink:href="jpis-40-194-g002"></graphic></fig><fig id="F3" position="float"><label>Figure 3</label><caption><p>After lingualized incision and retraction of the partial thickness flap, the implant fixture was uncovered.</p></caption><graphic xlink:href="jpis-40-194-g003"></graphic></fig><fig id="F4" position="float"><label>Figure 4</label><caption><p>Clinical photograph and three dimensional schematic drawing of the pre-fabricated implant-retained stent.</p></caption><graphic xlink:href="jpis-40-194-g004"></graphic></fig><fig id="F5" position="float"><label>Figure 5</label><caption><p>The stent was stabilized over the healing abutment. Additional sutures were placed on the mesial and distal side.</p></caption><graphic xlink:href="jpis-40-194-g005"></graphic></fig><fig id="F6" position="float"><label>Figure 6</label><caption><p>Clinical photo taken 1 month post-surgery. Slight shrinkage of the keratinized mucous zone was noted.</p></caption><graphic xlink:href="jpis-40-194-g006"></graphic></fig><fig id="F7" position="float"><label>Figure 7</label><caption><p>The final restoration was seated 3 months post-surgery. The apically positioned keratinized mucosa was well maintained.</p></caption><graphic xlink:href="jpis-40-194-g007"></graphic></fig><fig id="F8" position="float"><label>Figure 8</label><caption><p>Clinical photo of the implant area (A) before first stage implant surgery and (B) 4 months after first stage surgery. (C) Clinical photo of the provisional abutment connection with pre-fabricated implant-retained stent and (D) 2 months after second stage surgery.</p></caption><graphic xlink:href="jpis-40-194-g008"></graphic></fig><fig id="F9" position="float"><label>Figure 9</label><caption><p>Comparison of two techniques using an apically positioned flap (APF) with a partial thickness flap around the dental implants. (A) Periosteal and vertical line sutures. Dead space is created under the displaced flap and sutures are difficult and time-consuming. (B) The prefabricated implant-retained stent in the APF with partial thickness flap. Dead space is eliminated by vertical pressure from the stent, and no suture is required on vertical incisions.</p></caption><graphic xlink:href="jpis-40-194-g009"></graphic></fig><table-wrap id="T1" position="float"><label>Table 1</label><caption><p>Patient information and procedures.</p></caption><graphic xlink:href="jpis-40-194-i001"></graphic><table-wrap-foot><fn><p>PMH: past medical history, SLA: sandblasted large grit acid-etched.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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