Introduction
Alveolar ridge alteration likely occurs due to advanced periodontal disease, abscess formation, traumatic injuries, or tooth extractions and can lead to esthetic and/or functional compromises by the patient. Tissue loss may reduce either the buccolingual or the apicocoronal ridge dimension, or both, which leads to a deformed ridge. Seibert defined three qualitative classes (Class I – III) of ridge alterations based on this observation.1,2 In addition, a quantification of the tissue loss was suggested by Allen3 as follows: “… by assessing the depth of the defect relative to the adjacent ridge: mild = less than 3 mm, moderate = 3 to 6 mm, severe = greater than 6 mm.”
The esthetic reconstruction of such a defect is a challenge for the clinician. Periodontal plastic surgery is a treatment option available for establishing an optimal soft tissue contour to facilitate successful prosthetic reconstruction with fixed partial dentures. This approach requires close interaction between the periodontist, prosthodontist, and dental technician in order to meet the functional and esthetic demands of the patient.
There are patient-related factors that have to be kept in mind when planning for the use of periodontal plastic surgery. These include proper plaque control by the patient to eliminate periodontal inflammation and smoking cessation, if necessary, since cigarette smoking plays a major role in the outcome of periodontal plastic surgery.4,6 The patient needs to be informed about the healing and tissue remodelling time required before the final prosthesis can be fabricated since wound healing is a long-term process and tissue shrinking can be expected for several months after surgery.
This clinical report provides an approach for the treatment of moderate alveolar ridge defects. Surgical ridge augmentation using different soft tissue grafting procedures was performed using two steps.
