In this surgery, Prof. Dr. Hürzeler performs a special roll-flap procedure while uncovering an implant in the aesthetic zone. First, a de-epithelialization of the coronal tissue at the implant site is conducted. Next, an intrasulcular incision around the adjacent teeth is made using a microsurgical elevator. At the implant site, a full thickness flap is elevated and rolled in in order to thicken the buccal tissue. The goal is to prevent later gingival recession, and also the unaesthetic appearance of metal shining through a thin gingiva.
A releasing incision and tissue mobilization is conducted also in the palatal area in order to move tissue coronally. Now, the cover screw of the 3i implant is removed and a provisional cylinder placed. A temporary crown, which has been prepared in the dental laboratory, is fixated on the cylinder using light curing resin. Once an access hole to the implant cylinder is drilled, the temporary crown and cylinder are removed in order to be further customized and finalized in the laboratory.
The finished crown is then repositioned and fixated. With a special suturing technique, the flaps are positioned and fixated in a coronal position. For this technique a temporary resin bridge between the temporary crown and its neighboring teeth is used. Once the access hole in the crown is closed with resin, in a final step the buccally placed tissue needs to be stabilized with horizontal sutures. Using this roll flap technique, the thickening of the buccal tissue and the coronal positioning of the gingiva can be reached at the same time.