RESUMO
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 of vestibular gingival soft tissues, crucial for satisfactory engraftment and aesthetic 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 re-evaluated for up to 1 year. Digital impressions, taken with an intra- oral laser scanner and software, were analyzed before (day 0) and after (month 12) the treatment. The digital STL files were superimposed to assess volumetric and linear dimensional variations in selected peri-implant regions of interest (ROI) 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 the 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%) in 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 s; PI 0.19±0). Patients' liking of perceived pain/discomfort and aesthetic 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.
