Clinical Study: Immediate Implantation with Soft Tissue Augmentation in the Anterior Region

How combining immediate implantation with DFGG soft tissue augmentation ensures stable and aesthetic outcomes

Introduction

This case study presents the treatment of a 52-year-old patient with a darkened crown on tooth 21 and buccal bone loss. Radiographs revealed a previous root canal treatment with a periapical lesion. The objective was to address both functional and aesthetic challenges using immediate placement of a ceramic SDS implant (SDS1.2_4614) combined with soft tissue augmentation.

Objectives

The analysis focused on:

• Preservation and restoration of alveolar bone structure
• Regeneration of keratinized gingival tissue
• Optimization of anterior aesthetics, including gingival contour, tissue thickness, and color matching

Methodology

• Surgical procedure: Atraumatic extraction of tooth 21 followed by immediate placement of a SDS1.2_4614 ceramic implant.
• Soft tissue augmentation: Placement of a de-epithelialized free gingival graft (DFGG) from the palate to enhance gingival thickness.
• Healing support: Use of platelet-rich fibrin (A-PRF) to promote tissue regeneration and modulate inflammation.
• Follow-up: Clinical evaluation of stability, gingival contour, tissue texture, and color matching at 6 and 12 months.

Clinical Relevance

• Immediate implantation plus DFGG: Ensures bone and soft tissue stability, improves gingival thickness, and supports long-term aesthetic outcomes.
• Tulip design of the SDS implant: Provides mechanical support to the crestal bone during early healing.
• Practice recommendation: For patients with buccal bone loss and limited keratinized tissue, the combination of a SDS ceramic implant and DFGG is recommended to achieve optimal functional and aesthetic results.

Conclusion

This case demonstrates that immediate ceramic implantation combined with DFGG soft tissue augmentation secures alveolar stability and enables highly aesthetic anterior restorations. The tulip-shaped SDS implant further supports mechanical stability during healing, enhancing the long-term success of the treatment.

References

The full case report on ‘Immediate Implantation with Soft Tissue Augmentation in the Anterior Region’ can be found in the February 2025 issue of pIp Magazine.

Treating dentist and co-author of the study:

Dr. med. dent. Ilian Dargel

Graduated in 2005 from the University of Amsterdam (ACTA) and specialized in oral implantology, accredited by the Dutch Academy for Oral Implantology (NVOI). Founder of CIC, a private clinic for periodontology and implantology located in Castricum, the Netherlands.

@ Email 🔗 Website