Técnicas de manejo de tecido mole em próteses implanto-suportadas anteriores

Abstract

Considerable attention has been devoted to achieving a satisfactoryaesthetic result when necessary rehabilitation by implant-supported prostheses. Knowledge of such factors as a correct three-dimensional positioning of the implants, proper handling of soft tissues, both surgically and through the provisional and established a working prosthetic become imperative in aesthetic areas. In addition, certain requirements must be well prepared prior to implant placement to avoid compromising the esthetic result: the relative position of the tooth, a periodontal, periodontal biotype, shape the tooth, position the bonecrest. For this reason, some alternatives to management of soft tissue have been suggested to enhance and / or create keratinized gingiva around the implants to optimize both the aesthetic and to maintain homeostasis marginal. The management of soft tissue can be performed at different times, for the placement of the implant and abutment connection: preliminary approach, simultaneous, or delayed the reopening. The planning of peri-implant plastic surgery involves, in most cases, the use of soft tissue grafts (epithelized not epithelized or mixed) or specific manipulation of different pieces of adjacentdefects. The type of incision and suture containment papilla are also techniques to gain and preserve soft tissue peri-implant regions. Therefore, taking into account aesthetics, the ideal would be to use a particular technique for each type of situation or a combination of these techniques. According to the results evaluated, we can say that we should always restore the anatomy to have aesthetic, and for that we manage soft tissue before, during or after implant placement.