Post-operative soft tissue management
- The postoperative soft tissue management can coincide with the regular control recalls.
- The patient is seen one to two weeks after dental implant placement for suture removal, postsurgical instructions, and observation of healing. In case of one-stage or immediate loading protocols, soft diet is recommended for 30 days.
- The patients are instructed to rinse the mouth with 0.2% chlorhexidine mouthwash thrice a day without brushing the implant area until suture removal (7 to 14 days after).
- Evaluate wound healing and manage any signs of inflammation or infection.
- Patients would greatly benefit by having dental implants placed flapless, reducing the postoperative pain and consumption of analgesics.
Post operative soft tissue management - Timing
Following implant placement, patients receive oral and written recommendations about medication, oral hygiene maintenance and diet, depending on the type of surgical and prosthetic procedures.
Assessment of soft tissue during recall visits
The patients are instructed to rinse the mouth two to three times per day with an antiseptic mouth rinse with 0.2% chlorhexidine, starting the day after surgery and until suture removal (7 to 14 days after), without brushing the implant area.
Patients would greatly benefit by having dental implants placed flapless, reducing the postoperative pain and consumption of analgesics.
Similarly to the treatment of the edentulous, the patient is seen at day 1 - 3, day 7 - 14 and week for soft tissue control, management, and suture removal. In case of one-stage or immediate loading protocols, soft diet is recommended for 30 days.
Careful attention is given to the possibility of soft tissue, hard tissue, and/or dental implant infection, particularly to detect any signs of inflammation and infection such as swelling, exudate, pain, bleeding. In case of wound dehiscence re-suture and/or additional sutures (only within 24 to 48 hours) should be used. In case of post-extractive implants, the patients should be followed until completely soft tissue coverage.
The patient is seen again six weeks post-placement with the expectation that soft-tissue healing should be complete. Plaque when present, should be removed and oral hygiene instruction should be reinforced.
At this time, oral hygiene is reviewed and a maintenance appointment is scheduled. Three months post-placement a radiograph is taken to evaluate hard-tissue levels.
Soft tissue and provisional denture fit
In case of immediate loading, the clinician should carefully control the fit of the provsional restoration to avoid tissue trauma. If cemented retained restoration have been apply, excessive control of the cement should be carefully and meticulous removed. Since soft tissues change during the healing, the temporary restoration should be customized accordingly. Nevertheless, it is preferable avoid any removal of the temporary restoration during the first 6-8 weeks of healing.
Figure 1: Pre-extaction Figure 2: Extraction Figure 3: 7 days suture removal Figure 4: 14 days
Figure 5: 3 weeks Figure 6: 6 weeks Figure 7: 7 days after implant placement (IP) and guided bone regeneration (GBR) procedure Figure 8: 14 days after IP and GBR procedure.