Fold-Over Flap Technique for Developing the Facial Gingival Contour: A Case Report
A dental implant surgical technique is described including a 12-mm fold-over of a facial flap and coapting the internal side of the folded flap with a 4-0 suture. The flap is pulled against a provisional crown with a sling-type suture during the implant uncovery stage and may decrease the risk for a poor esthetic facial gingival architectural outcome.
Figure 1. The site was ridge mapped by a bone sounding and impression technique to determine the remaining bone volume. Figure 2. The atrophic bone ridge was split and expanded to the facial. Figure 3. An implant analogue was placed and the facial bone segment was deemed inadequate for gingival support. Figure 4. The implant was placed, and particulate bone allograft and a collagen barrier membrane were placed. Figure 5. A bonded denture tooth was used as a provisional prosthesis.
Figure 6. A schematic of the 12-mm gingival flap. Figure 7. The healed site before the fold-over flap was cut. Figure 8. A schematic of the sling suture technique. Figure 9. The healing flap at 2 weeks. Figure 10. The gingival contour at 3 years. Figure 11. Healing #6 site at 1 week of a facial fold-over flap. Figure 12. Healing #6 site at 3 weeks. Figure 13. Healed #6 site at 1 year.
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