Is Soft Tissue Important around an Implant?

The early healing looks favorable. I might have added some bone allograft at the same time that I was doing the SECT. For now, I would just monitor the area

Is soft tissue important around an implant ? Depends. Soft tissue that hides ugly abutments is important. Soft tissue that forms deep pocket spaces around an implant becomes a breeding ground for bacterial growth as it is a space that is isolated, deep, warm, filled with food debri ( bugs love those carbo's/sugars ) and impossible to clean. Soft tissue that acts as a physical barrier ( attached ) is beneficial. Soft tissue that does not act as a barrier ( around most implants ) is not beneficial. So the answer to your question depends on the way you choose to look at soft tissue.

This looks like a good result. Can you clarify how long after grafting was the final photo taken? It seems to be quite soon after initial healing. How much extra height did you gain with the graft? It seems like 0.5 mm but it is hard to see. Do you have a photo 2 to 4 years post op? The result looks good but obviously while short term results are desirable, any intervention requires stable, acceptable, quantifiable long term results to be justified. It seems to me that you are on the right track but I would be very interested in answers to the above questions.

The research shows that much of the blood flow that supports a thin biotype (= thin soft tissue and thin bone) comes from the PDL. When you take that away then the bone and or soft tissue recede more. As you look at your cases long term you'll see that the thick biotype cases (= more blood flow to supports the peri-implant structures) have more stability (ie no recession). Generally the data shows that 1.5-2mm thick soft tissue and 2mm of bone thickness will give optimal stability. Do we always get that? NO!!! What role does keratinized tissue play?? Clearly you'd benefit with working more closely with a well trained, up to date Periodontist. At major implant meetings you will regularly hear the key opinion leaders continue to talk about this, since it is hard for referring Dr's to support and another barrier for patients to accept. go out of your way to see Uri Grunders work. He shows cases with long term stability 20-25 years old!! Remember that as the tissue recedes then the rough part of the implant gets exposed and that is impossible to clean. A lot of the peri-implantitis I deal with is recession driven: my cases and those of others as well. Do a literature search on the topic.

Good effort. Only time will reveal the results of the healing. Exposed buccal threads are an issue that any dentist that has placed many implants will eventually face. What did you use to clean the threads before placing the CTG? I personally would have used PRP to make some "sticky bone" with a graft material in hopes of a best outcome covered with a PRF "membrane". I hope you post follow up. These cases are very valuable for those of us that face these problems. Thanks for posting..