Optimizing Aesthetic Outcomes in the Maxillary Region: A Case Report on the Role of Autogenous Bone and Connective Tissue Grafts

Auteurs: Ikram Attouchi, Ghada Bouslama, Nour Sayda Ben Messaoud ,Aya Mtiri ,Lamia Oualha, Souha Ben Youssef

Abstract:

Achieving optimal aesthetic outcomes in the maxillary region can be challenging, particularly when addressing horizontal alveolar ridge defects and peri-implant soft tissue deficiencies. These deformities may result from various factors, such as tooth loss due to extraction, advanced periodontal disease, or trauma. Dehiscence and fenestration defects can also contribute to these challenges. Implant placement in alveolar deficiencies may lead to adverse angulations, mechanical overload and compromised esthetic and functional outcomes of the dental prosthesis. As a result, augmentation of the deficient bone is often necessary to reconstruct the residual alveolar ridge, allowing for ideal implant placement. Among the available techniques, autogenous bone grafting remains the gold standard for horizontal ridge augmentation due to its osteogenic, osteoconductive, and osteoinductive properties. This method provides predictable bone regeneration, ensuring sufficient bone volume for implant placement in cases of ridge atrophy. However, the success of implant therapy in the aesthetic zone is influenced not only by bone volume but also by the quality and quantity of the peri-implant soft tissue. To address this, the use of a connective tissue graft offers a dual advantage: enhancing soft tissue thickness and contour while promoting long-term stability of the peri-implant mucosa. The aim of this report is to present a clinical approach that combines autogenous bone graft for horizontal ridge augmentation with connective tissue graft to improve soft tissue contours around dental implants in the aesthetic zone. We present a successful case of horizontal ridge augmentation in the anterior maxilla using block bone autografts harvested from the mandibular symphysis. Six months post-surgery, the implant was placed, and after a healing period of five months, the final prosthetic restoration was successfully completed.

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