Laterally rotated flap for soft tissue augmentation around maxillary loaded osseointegrated dental implants: preliminary results of a pilot study.

A minimal width and thickness of keratinized and attached soft tissue is desirable to prevent peri-implant diseases. This report describes the preliminary results of a pilot study of a surgical approach for soft tissue augmentation around loaded dental implants in the partially or totally edentulous maxilla. Four patients presenting eight maxillary implants with a buccal peri-implant soft tissue deficiency received a laterally rotated flap. A buccal mesial and apical recipient area was created around each implant, and a pediculated keratinized graft was rotated 90 degrees from the distopalatal and positioned and sutured on the peri-implant buccal aspect. All implants treated showed a gain in buccal clinical peri-implant attachment (1.37 +/- 0.44 mm) and buccal soft tissue levels (2.06 +/- 1.40 mm) and interproximal soft tissue levels (1 +/- 0.75 mm). The technique provided quality soft tissue with a gain in soft tissue thickness (3.06 +/- 0.68 mm) and keratinized wide tissue (4.69 +/- 0.80 mm) with minimal morbidity (1575 +/- 549.67 mg of ibuprofen) and maintenance of prosthetic loading. Peri-implant soft tissue stability was maintained for 13.5 +/- 1.87 months. Laterally rotated flap can be applied and provide clinical benefits to compromised implants due to the presence of buccal peri-implant soft tissue deficiency. Further studies are required to confirm these preliminary results.