SURGICAL MANIPULATION OF SOFT AND BONE TISSUE IN CONTEMPORARY DENTAL IMPLANTOLOGY
DOI:
https://doi.org/10.35120/kij5404639pKeywords:
dental implants, soft tissue, hard tissue, surgical interventionsAbstract
Adequate and correct manipulation of soft and bone tissues during implant therapy is extremely
important. Knowledge of the biological, histological and of course the surgical characteristics of the tissues can
largely be a predictor of the correct implant prosthetic rehabilitation. The main aim of this research was to describe
all aspects of surgical manipulation of the soft and bone tissues during the dental implantology procedures. We have
made adequate literature research for articles relevant to our topic-surgical manipulation of the soft and hard tissues
during the dental implantology procedures published in the last two decades (2001-2021). Kew words used for the
research were: “surgical manipulation”, “dental implantology”, “soft tissues”, “bone tissues” and their combination.
Each implantologist should take into account the biological limitations of each patient, as well as the technical
limitations that may occur during the treatment. Oral soft tissues can be affected during the various stages of the
implant treatment. During the planning of a surgical intervention such as the placement of an implant, regardless of
whether it is an immediate or a delayed loading implant, it is necessary to have an adequate manipulation of the
surrounding soft tissue and bone structures. When designing the flap should be taken into account the degree of
accessibility required to access the bone, as well as the final position of the flap. It is also of great importance to take
into account the preservation of good blood supply to the flap. Based on the exposure of bone after elevation, flaps
can be classified as either full-thickness or mucoperiosteal flaps and partial-thickness or mucosal flaps. Depending
on how the interdental papilla will be treated, the incisions can either divide the papilla (conventional incision) or
preserve it (papilla-preserving incision). Based on the placement of flaps after surgery, they can be classified as: 1)
nondisplaced flaps, where the flap is returned and sutured to its original position, or 2) displaced flaps, which are
placed apically, coronally, or laterally from their original position. The work in bone is quite complex and requires
knowledge of its morphological and histological characteristics. When working on bone, and especially when
placing dental implants, it is necessary to note that it is necessary to enable constant cooling. The improvement of
old techniques and the development of new technologies have created a revolution in oral implantology, and now a
therapist has numerous therapeutic options that can be incorporated into daily practice to facilitate the surgical
approach itself. Hard-tissue and soft-tissue dental lasers, which are constantly improving and have a wide range of
indications, are becoming a part of everyday dental practice and also show significant advantages compared to
conventional instruments and techniques when placing dental implants. Therefore, over time they will become an
invaluable and irreplaceable tool in modern dental implantology. After the performed extensive and deductive
literature review, it can be concluded that from particular importance is the correct manipulation of soft and bone
tissues during dental implantation. After tooth extraction, the placement of dental implants is largely determined by
the integrity of existing hard and soft tissues, such as the aesthetic outcome from the prosthodontic suprastructure
over dental implants. Careful assessment of soft and bone tissue loss during implantation is paramount to the success
of aesthetic implant procedures
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