Soft tissue management for immediate implant placement in the esthetic zone is crucial for successful treatment outcomes. Several surgical and restorative techniques have been proposed to treat unesthetic implant soft tissue defects or dehiscence. However, there is a scarcity of clinical evidence on addressing complications associated with through-and-through soft tissue defect (TTSD). In this case, a 61-year-old female patient, who underwent immediate implant placement at the right central incisor 3 months prior, presented with chronic peri-implant mucosal infection and soft tissue recession of TTSD in 2015. The palatal pedicle connective tissue flap (PPCTF) was utilized to provide horizontal and vertical soft tissue augmentation and to cover the defect in combination with the labial contour collapse. At the 8-year follow-up, favorable white and pink esthetic outcomes were observed, and the pink esthetic score (PES) for soft tissue around the implant achieved 9 points, indicating satisfactory esthetic and functional results. The findings from this case study suggest that soft tissue augmentation techniques, such as PPCTF grafts, can provide a reliable and innovative method for both soft tissue augmentation and reconstruction of TTSD, resulting in long-lasting functional and esthetic outcomes and stable ideal PES scores.
Keywords: esthetic zone; immediate implant placement; palatal pedicle connective tissue flap; soft tissue augmentation; soft tissue defect.
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