Reconstructive Peri‐Implantitis Surgery Using an Internally Beveled Vestibular Incision for Multilayer Wound Closure.

Objective: As the outcome of reconstructive peri‐implantitis surgery is highly dependent on complication‐free healing with focus on primary intention healing, clinicians should take into account that the wound healing capacity at peri‐implant sites is compromised due to fundamental structural biolog...

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Bibliographic Details
Published in:Journal of Esthetic & Restorative Dentistry Vol. 38; no. 3; pp. 565 - 575
Main Authors: Gülnergiz, Erdem, Abraha, Sophia M., Hürzeler, Markus, Zuhr, Otto
Format: diagnostic images pictorial Journal Article
Published: Wiley-Blackwell Mar2026
Online Access:View this record in EBSCOhost
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        14964155
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      jtl: Journal of Esthetic & Restorative Dentistry
      issn: 14964155
      maglogo: Y
    pubinfo:
      dt: Mar2026
      vid: 38
      iid: 3
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        192872470
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        10.1111/jerd.70124
        192872470
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      formats:
      tig:
        atl: Reconstructive Peri‐Implantitis Surgery Using an Internally Beveled Vestibular Incision for Multilayer Wound Closure.
      aug:
        au:
          Gülnergiz, Erdem
          Abraha, Sophia M.
          Hürzeler, Markus
          Zuhr, Otto
        affil: Private Practice Hürzeler/Zuhr, Munich, Germany
      sug:
        subj:
          Surgery, Reconstructive
          Peri-Implantitis Surgery
          Wound Healing
          Surgical Flaps Utilization
          Wound Care
          Dental Implants
          Aesthetics, Dental
          Suture Removal
          Autografts
          Soft Tissue Injuries Prevention and Control
          Radiography, Dental
          Equipment Contamination
      ab: Objective: As the outcome of reconstructive peri‐implantitis surgery is highly dependent on complication‐free healing with focus on primary intention healing, clinicians should take into account that the wound healing capacity at peri‐implant sites is compromised due to fundamental structural biological differences when compared to periodontal tissues. In this context, tunneling flap techniques that avoid superficial incisions in the interproximal soft tissues, specifically between adjacent implants, where the papillary region constitutes a critical weak point, can be a key strategy. When employed together with vestibular access flaps, precise multilayer closure techniques may be applied to stabilize the wound within the highly movable alveolar mucosa and in this way improve predictable primary wound healing. Clinical Considerations: An internally beveled vestibular incision in the alveolar mucosa is introduced and described in this article. After flap preparation and implant surface decontamination, defects were reconstructed using autogenous tuberosity bone. Executing the initial bevel from coronal to apical (internal) created an additional tissue wedge that was incorporated into the coronal flap margin, increasing its surface area and facilitating closure in four distinct layers. Conclusion: The modified approach resulted in primary wound healing in these cases and was associated with substantial reconstructive outcomes at 1 year. Clinical Significance: Preserving peri‐implant papillary integrity by an internally beveled vestibular incision together with multilayer suturing may be beneficial to attain predictable healing by primary intention after reconstructive peri‐implantitis surgery, which is also relevant in esthetic areas.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        Journal Article
      ougenre: Article
    language: English
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