Soft tissue dehiscence after uncovery: recommendations?

The goal is to cover exposed bone by whatever option available and there are a few. One would be coronal repositioning of the flap, PTFE membrane, tissue graft.

Just wondering why an impression is required after soft tissue is manipulated 1 week prior? Is this for final prosthesis?

This is what I would do, Leave it until 4 weeks . The bone will be covered on its own then taken impression . Justbe patient little more.

Interesting case, thanks for sharing. How much exposed bone are we talking about? A sliver? 1 mm? 2 mm? More? How did you remove the bone that was covering the cover screw? A drill? I suspect that if you used a drill you overheated that palatial bone -or- you beat up the palatal flap too much when doing your dissection? When I have to uncover something I only use a room heir and/or a 15 blade. Anyways, you have a region of dead bone. I don't think covering it with any kind of advancement flap at this stage will work because it will just dehisce. I think you will have to wait until the dead area declares itself an sloughs. That will most likely leave you with exposed threads. At that point you could reflect a flap, etch the exposed area, then regrant the exposed area. Be generous with the size of your flap and score the periosteum on the underside of the flap to release tension. Then make sure you have a tension-free closure. And tell that patient to quit smoking ;)

Can't give any useful advice without an X-ray or clinical picture. I suppect that after exposure either a thin maxilla with implants placed too far to the lingual, rough exposure during healing head placement, smoking, manipulation by the patient's tongue. I do know one thing I would not have scraped the area with plastics scalers and used H2O2 and CHX to further traumatize the area. The appearance of the bone is key. Exposed bone is usually dead bone which will slough. Any healing granulation tissue most likely was removed by your premature intervention. Most of the listed comments won't help you, show a lack of understanding of surgical healing process. Hope you have a good informed consent. Let it heal and restore, palatial exposure is difficult to fix. Clinical judgement.

CRS would like to see an x-ray to evaluate palatal exposure. A periscope would do better. We tend to exaggerate just about everything for whatever reason. Call it professional liability. We all had experiences like this and everything ended well. Open limb fractures are treated without complication and a little bone exposure in the mouth will heal as well. Removing healing abutment and non-resorbable membrane like PTFE will solve the problem for sure. We take teeth out, graft bone and place a PTFE membrane according to protocol for the use of that type of membrane and much more bone gets covered. With the knowledge you most likely already have, you will find a solution.

Leave it alone; let it heal via secondary intention

Exposed bone is dead bone , grafting over it will do nothing and will fail , you can't do anything right now just wait and see secondary healing takes place and hope for the best (been in the same situation with a smoking patient their lack of soft tissue healing potential will leave you frustrated sometimes), schedule weekly appointments to remove dead bone sloughs and make the patient use cotton swabs with CHX in this particular area.

A picture would be helpful, but I agree that discretion makes sense. Let it heal and see what happens. Definitely, stop or reduce smoking ASAP. In general, I would wait at least 3-4 weeks before taking an impression. Good luck