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Prof. Dr Dr Anton Sculean (Bern), attending remotely, talked about options and limitations when covering implant recessions. Citing the differences in biological anchorage between natural teeth and implants, he explained that implants are in direct contact with the bone and that the soft tissue surrounding them is less vascularised than that around teeth, which has to be taken account in soft-tissue surgery. According to Sculean, there are two components to the mucosal seal –connective-tissue integration and the epithelial layer. The former in particular is of major importance if infections arise in this area. Aetiological factors of any soft-tissue recession at implants primarily include incorrect implant placement – too far buccally or labially or, conversely, too far palatally or lingually. Other aetiological factors include the absence of a bony envelope and excessive implant diameters relative to the existing bone supply; an excessive number of implants; insuffi cient distance between implants, causing the loss of the interimplant papilla; insuffi cient distance between implants and natural teeth; insuffi cient mucosal thickness or insuffi cient attached keratinized mucosa; and, of course, peri-implant mucositis and peri-implantitis. The only appropriate comment if implants are placed too far outside the bony envelope, said Sculean, would be “Mission Impossible” – here the only possible action would be to remove the implant or implants altogether.

What kind of tissue recession, then, remains amenable to coverage around implants? Sculean believes that successful treatment is possible if the dehiscence is no deeper than 2–3 mm, 4 mm at the very most, or if the implant is reasonably fi rmly positioned within the bony envelope. He then proceeded to present some of his cases using the modifi ed (MCAT) and lateral (LCT) tunnelling techniques. The idea, he said, is not to separate the papillae but to expose this area as part of a mucoperiosteal tunnelling procedure, so that new tissue – such as a connective-tissue graft – can be introduced to reinforce the tissue. The important thing here is tension-free preparation. – For Sculean, tunnelling techniques are a good option for addressing small mucosal defects, as long as the implant is not too far outside the bony envelope, as pointed out previously.

Embracing the Future

BDIZ EDI partner of the Nepalese Society of Implant Dentistry

A reliable treatment option

European Consensus Conference EuCC) presents recommendations for short, angulated and reduced-diameter implants

Risk assessment at a glance

Guideline 2022: Cologne ABC Risk Score for implant treatment

Minimally invasive implant treatment

At the 17th Expert Symposium of BDIZ EDI in Cologne 2022 Professor Stefan Fickl discussed the interface between periodontology and implantology.

Periodontal rehab

Professor Jörg Neugebauer’s lecture on periodontal rehabilitation with All-on-4 at the Expert Symposium in Cologne 2022.

At a glimpse: North Macedonia

Statement by Dr Fisnik Kasapi, President of AIAM, EDI Macedonia

At a glimpse: India

Statement by Dr Vikas Gowd, EDI India

At a glimpse: The Netherlands

Statement by Dr Jan Willem Vaartjes, President of the Association of Dutch Dentists (ANT)

At a glimpse: United Kingdom

Statement by Dr Eimear O’Connell, President ADI UK

Statement on the fighting in Ukraine

Joint press release of BDIZ EDI and partner associations