Management of peri-implant keratinized tissue deficiency following roll flap complication: A case report

Adequate peri-implant keratinized tissue is crucial for the maintenance of implant health and long-term success. This case report presents the management of a soft tissue complication arising from an initial attempt to augment peri-implant keratinized tissue. A 43-year old female patient presented with a lack of keratinized tissue around an implant. A roll flap technique was first employed to increase tissue volume; however, it led to an undesirable coronal shift of the mucogingival junction and further reduction of the peri-implant keratinized tissue. To address this complication, a free gingival graft was subsequently performed. The procedure resulted in a significant increase in peri-implant keratinized tissue, promoting healthy peri-implant conditions and supporting long-term implant stability. This case highlights the importance of selecting appropriate techniques for soft tissue management around implants.