In patients with severe atrophies of bone, the placement of dental implants with or without bone grafting often is the only possibility for oral rehabilitation. The success is still limited due to an unfavourable soft tissue situation. A tensionfree wound closure is necessary and often achieved only by a periosteal release-incision, this may result in a deficit of keratinized mucosa after uncovering of the implants. For a good functional and esthetic longterm result, often soft tissue augmentation procedures have to be performed. Connective tissue grafts and free gingival grafts are recommended as standard procedures to create a stable peri-implant surrounding.
Disadvantages are the morbidity and the size limitation of the donor site area.
An acrylic splint is fixed on the implants for 10 days. Prosthetic treatment is finished 4 weeks after soft tissue surgery. Preoperative x-ray for implant insertion. A cortico- cancellous bone graft from the iliac crest was inserted for bone reconstruction after tumor resection of the mandible. Clinical situation after implant insertion.