Gum recession around dental implants can result in aesthetic compromise and inflammation with pain. This condition is often due to thin or missing bone or poorly positioned implants with excessive angles. Treatment options depend on the health of the implant, available bone, and position of the implant. Treatments range from management of the recession by a gum graft to implant removal, bone and gum tissue augmentation, and replacement with a new implant.
This patient presented with recession and dehiscence (opening) of the gum tissue on the outer aspect of his lower dental implant. The contributing factors included thin bone and the presence of frenum (muscle) attachments close to the gum line. The implant was otherwise stable with healthy bone and no evidence of peri-implantitis.
The treatment plan consisted of the following:
- Removal of the existing crown and abutment
- Allow natural healing of the gum tissue over the implant (2 months)
- Gum tissue graft to increase its thickness and zone of attached gingiva (keratinized gingiva) along with frenectomy (reduction of muscles attachments away from the gum line)
- Allow 3 months of healing.
- Implant exposure
- Placement of a new custom abutment and restoration
Through this staged treatment and bio-transformation of the gum tissue from thin to thick, we could stabilize the implant and surrounding bone and gum tissue and restore proper health.
Also, check out this video discussing gum recession around dental implants:
Thanks to Dr. Brian Gray at Giannini & Gray Dental Partners for his collaboration
Dr. H. Ryan Kazemi is a board-certified oral and maxillofacial surgeon in Bethesda, MD