Oral and Maxillofacial Surgery Expert Forum
Gum grafting on an exposed implant
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Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr. Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.

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Gum grafting on an exposed implant

I'm very concerned.  I had an implant that failed, it was removed and I had bone grafting, then I had another implant surgery.  The bone and gum on the out-facing side of the implant receded and a good portion of the implant is exposed. It was recommended that I have gum surgery prior to having the crown placed on the implant because so much of the implant is exposed - it is very ugly looking.  The other option is to have a special crown made that extends up over the implant with a fake gum line.
What would you recommend?  What is the success rate for gum surgery over a metal implant? What is the success rate of using connective tissue vs tissue out of a jar for gum grafting?
Thank you so much!
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A free gingival graft will not work to cover the implant unless there is bone between the implant and the gum tissue.

My suggestion is to have a bone graft with guided tissue and bone regeneration to cover the implant.  This would not only yield the best cosmetic results, but would strengthen the implant by better bone contact.

The other prosthetic option may be to have pink porcelain cover the exposed implant.  I do not like this option.  Maintenance is very difficult and worsening of gum tissue can occur.

Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
2 Comments
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if as described, do bone grafting the the outerside of the implant, if using patient's real bone: marrow which is taken from patient's knee, will that part of bone grafting will finally grow as patient's own bone and integrated with the implant? Thanks.
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A related discussion, bone transplant. was started.
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373693_tn?1324489102
Michael H Kirsch, DDSBlank
Dr. Michael H. Kirsch
Caldwell, NJ
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