Management of a malpositioned implant with peri-implant mucosal dehiscence. Combined prosthetic-surgical-orthodontic treatment.

Abstract

The present case report provides a comprehensive guide to treating malpositioned implants with peri-implant mucosal dehiscence in the esthetic zone, a common yet challenging complication in implant therapy. It emphasizes the importance of evaluating implant restorability as a first step. The treatment detailed in this report adopts an interdisciplinary approach, integrating prosthetics, periodontics, and orthodontics. It starts with altering the prosthetic components to promote mucosal margin migration. After soft tissue maturation, a surgical procedure is employed that combines a modified tunnel technique with a connective tissue graft. This is followed by slow orthodontic extrusion to adjust the position of the adjacent teeth, enhancing papillae fill. The process concludes with the stabilization of the periodontal and peri-implant tissue, allowing for the final impressions and cementation of the restorations.