Iñaki Gamborena: Esthetics in the anterior region

Sufficient soft tissue volume and natural scalloping contour is key for esthetic success. Dr Gamborena is discussing aspects of soft tissue management criteria, innovative connective tissue graft and healing abutment design, and related flap, suturing and restorative considerations. The one abutment-one time concept is of importance in situations without soft tissue graft, but less important when soft tissue grafts are placed. Dr Gamborena prefers connective tissue grafts (CTG) from the tuberosity region as this tissue contains a considerably higher amount of collagen in comparison to palatal CTG. Dr Gamborena presents how this tuberosity CGT can be ideally combined with a new generation of slim healing abutments, in order to not only build up buccal soft tissue, but graft comprehensively from a crestal standpoint, mesio-distally and bucco-lingually. This type of grafting procedure shows long term tissue stability and a noticeable creeping effect. Dr Gamborena emphasizes that overgrafting the bone can compomise the needed space for soft tissue which can lead to problems.