Soft-Tissue Augmentation Around Dental Implants by a New Laser-Aided Pouch Roll Technique: Volumetric and Clinical Evaluation After 1 Year

Abstract

The ultimate goal in implantology is to restore the whole tooth–gingival complex in a fashion that cannot be distinguished from the rest of the natural dentition. This study assesses the volumetric and clinical changes in vestibular gingival soft tissues, crucial for satisfactory engraftment and esthetic results, upon treatment with laser-aided pouch roll augmentation in second-stage surgery for dental implant uncovering. Twelve patients with mild ridge deficiencies in 16 edentulous sites, including distal elements, were enrolled and reevaluated for up to 1 year. Digital impressions, taken with an intraoral laser scanner and software, were analyzed before (day 0) and after (month 12) treatment. The digital STL files were superimposed to assess volumetric and linear dimensional variations in selected peri-implant regions of interest by 3D analysis software. Clinical periodontal parameters (probing depth [PD], bleeding on probing [BoP], plaque index [PI]) and subjective patient-reported outcomes were also evaluated. In all patients, the applied technique induced a substantial increase in the volume of the vestibular peri-implant gingiva at 12-month follow-up (range, 24%–69%, mean 40.4%) with respect to day 0. The gingival mucosa appeared normal at both inspection and evaluation of the periodontal parameters (PD 2.7 ± 1 mm; BoP 0.11 ± 0.2 seconds; PI 0.19 ± 0). Patients’ satisfaction with perceived pain/discomfort and esthetic outcome was high. These findings indicate that laser-aided pouch roll flap is a safe, patient-liked procedure whose long-term effectiveness has been objectively demonstrated by volumetric and clinical assessment.