Soft tissue management in aesthetic implantology: clinical case with 15-year follow-up

OBJECTIVES Implant therapy is widely recog nized as an effective and predict able solution for replacing missing teeth, supported by extensive sci entific evidence. From the patient’s perspective, the success of implant therapy is assessed not only based on the long-term functionality of the implant but also on the imme diate aesthetic result and its stabil ity over time. The objective ofthis article is to describe the key steps for proper implant placement, bone reconstruction, and the correct management of soft tissues to en sure an aesthetically functional outcome with long-term follow-up. MATERIALS AND METHODS A 57-year-old female patient pre sented with persistent pain in tooth 1.3 and significantgingival reces sion, leading to the extraction of the tooth. A Free Gingival Graft (FGG) was performed to stabilize the site and promote healing, using a mini mally invasive technique to preserve the alveolar wall. After four months, a 3.5 mm implant was placed with Guided Bone Regeneration (GBR) using a combination ofdeprotein ized bovine bone and autologous bone. Eight months post-surgery, a Connective Tissue Graft (CTG) was applied to enhance gingival contour. The final prosthetic rehabilitation included a screw-retained zirco nia crown, with successful fol low-up showing healthy peri-im plant tissues and minimal bone loss. CONCLUSIONS The results of the study demon strate the long-term success of the combined surgical and prosthetic techniques used in the case. One year after the final rehabilitation, © 2025 EDRA SpA. Tutti i diritti riservati Doi: 10.19256/d.cadmos.01.2025.08 the peri-implant tissues remained healthy, with a stable gingival pro file, without signs of inflammation or significant bone loss. At 5-, 10- and15-year follow-up, the soft tis sues showed morphological and dimensional stability, with minimal marginal bone resorption. These results highlight the effectiveness of integrating mucogingival, regen erative and prosthetic techniques in ensuring lasting functional and aesthetic results. The multidisciplinary approach ad opted ensured long-term stability in hard and soft tissue, highlighting patient satisfaction with the aes thetic and functional results. This demonstrates the effectiveness of combined mucogingival, regenera tive and prosthetic techniques. The results emphasize the importance of integrated planning and treat ment toaddress similar clinical gennaio/2025 DENTAL CADMOS complexities, ensuring optimal pa tient outcomes. CLINICAL SIGNIFICANCE The article highlights how hardand soft tissue management is crucial for aesthetic and functional stability in implant therapies, particularly in visible areas. By using soft tissue grafts and biomaterials, bone vol ume and structure can be main tained after extraction, reducing the risk of bone resorption. This tech nique improves peri-implant tissue stability, preventing complications and optimizing implant health and the final aesthetic result.