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A 53-year-old healthy Hispanic male was diagnosed with PSTD class III C. The abutment and crown were modified to support a coronally advanced flap (CAF) and accommodate a tissue graft, followed by a CAF with tuberosity connective tissue graft. After eight months of healing, the PSTD and peri-implant soft tissue dimensions improved significantly, with high patient satisfaction.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/management-of-peri-implant-soft-tissue-dehiscence-with-combined-prosthetic-surgical-approach-a-case-report/458276/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/management-of-peri-implant-soft-tissue-dehiscence-with-combined-prosthetic-surgical-approach-a-case-report/458276.png","ImageObject",300,407,{"name":92,"@type":93},"\tCallum ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What problem does this case report address?","Question",{"text":112,"@type":113},"It addresses peri-implant soft tissue dehiscence (PSTD) presenting as an esthetic complication around a dental implant.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was PSTD class III C treated in this report?",{"text":117,"@type":113},"Treatment combined prosthetic modification of the abutment and crown with a coronally advanced flap (CAF) and a tuberosity connective tissue graft.",{"name":119,"@type":110,"acceptedAnswer":120},"What outcomes were reported after healing?",{"text":121,"@type":113},"After eight months, there was significant improvement in PSTD, peri-implant soft tissue dimensions, and patient satisfaction, with improved tissue health, thickness, and appearance.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},458276,1791159626,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},137451211410,"https://ap-avatar.wpscdn.com/avatar/2000bb0a9246f588df?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786362646172706240","DOI: 10.1002/cap.70039  \nCASE STUDY  \nManagement of peri-implant soft tissue dehiscence with combined prosthetic-surgical approach: A case report  \nOmran Bishbish Zeino   Yoon Jeong Kim  \nDepartment of Periodontics, Loma Linda University School of Dentistry, Loma Linda, California, USA  \nCorrespondence  \nOmran Bishbish Zeino, Loma Linda University School of Dentistry, Loma Linda, CA, USA. [Email:](Email: dr.omran_m@yahoo.com)[ dr.omran_m@yahoo.com](Email: dr.omran_m@yahoo.com)  \nAbstract  \nBackground: This case report presents the management of an esthetic complication of a peri-implant soft tissue dehiscence (PSTD) through a combined prosthetic-surgical approach.  \nMethods and Results: A 53-year-old healthy Hispanic male presented to our practice for the treatment of an implant esthetic complication. A diagnosis of PSTD class III C was established. The abutment and crown were first modified to accommodate the tissue graft and support the coronally advanced flap (CAF) . Then, a CAF with tuberosity connective tissue graft was performed. A definitive abutment and crown were fabricated 8 months after healing. Significant improvement of the PSTD, improvement of the peri-implant soft tissue dimensions, and patient satisfaction have been achieved.  \nConclusion: A combined prosthetic-surgical approach constitutes a valid treatment modality for PSTD class III C where there is abundant interproximal tissue available.  \nKEYWORDS  \nconnective tissue, dental implants, patient satisfaction, soft tissue dimension, soft tissue grafting  \nKey points  \n∙ Integrated treatment approach: A combined prosthetic-surgical technique offers an effective solution for managing peri-implant soft tissue dehiscence (PSTD), ensuring improved tissue thickness and stability.  \n∙ Clinical considerations: The bucco-lingual implant position and interproximal tissue quality are key factors in determining the optimal treatment strategy.  \n∙ Predictable outcomes: Coronally advanced flap combined with connective tissue grafting can enhance esthetic and functional results for management of PSTD.  \nPlain language summary  \nPeri-implant soft tissue complications can affect both the function and appearance of dental implants. This case study explores an approach that combines surgical and prosthetic techniques to improve the gingival tissue surrounding an implant. A 53-year-old patient had an esthetic concern due to gum recession around his implant. To correct this, his dental crown and abutment were adjusted. Then, a gingival grafting procedure to reposition the gingival tissue and enhance its thickness was performed. After healing for eight months, the implant was  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \n© 2025 The Author(s) . Clinical Advances in Periodontics published by Wiley Periodicals LLC on behalf of American Academy of Periodontology.  \npermanently restored with a final crown. The results showed significant improvements in gingival tissue health, thickness, and appearance, leading to patient satisfaction. The findings highlight how combining surgical techniques with prosthetic adjustments can help manage similar cases, offering a predictable solution to improve both the appearance and stability of dental implants.  \nINTRODUCTION  \nPeri-implant soft tissue dehiscence (PSTD) is defined asan alteration of the peri-implant soft tissue architecture characterized by an apical discrepancy of the peri-implant mucosal margin with respect to its ideal position.1 This case report presents the management of a PSTD with an esthetic complication through a combined prostheticsurgical approach. The objectives of treatment were to improve the level of the peri-implant mucosal margin, optimize the dimensions of the peri-implant soft tissue, and ensure patient satisfaction. CARE reporting guidelines were followed duri","cbCaidY9MqbDMrjK","https://ap.wps.com/l/cbCaidY9MqbDMrjK","pdf",4238333,"English","# Abstract\n## Background\n## Methods and Results\n## Conclusion\n# Key points\n# Plain language summary\n# Introduction\n# Materials and Methods\n## Clinical presentation","[{\"question\":\"What problem does this case report address?\",\"answer\":\"It addresses peri-implant soft tissue dehiscence (PSTD) presenting as an esthetic complication around a dental implant.\"},{\"question\":\"How was PSTD class III C treated in this report?\",\"answer\":\"Treatment combined prosthetic modification of the abutment and crown with a coronally advanced flap (CAF) and a tuberosity connective tissue graft.\"},{\"question\":\"What outcomes were reported after healing?\",\"answer\":\"After eight months, there was significant improvement in PSTD, peri-implant soft tissue dimensions, and patient satisfaction, with improved tissue health, thickness, and appearance.\"}]","Management of peri-implant soft tissue dehiscence with combined prosthetic-surgical approach - A case report | PDF",1790752442,18]