In this insightful "Just Ask" session, host Garrett Heikope sits down with Dr. Paulo Carvalho, a renowned expert in implant dentistry from Porto, Portugal, to discuss the complexities of managing soft tissue defects in the aesthetic zone. This area of dentistry is increasingly important as patients demand more natural-looking restorations that mimic the appearance of real teeth.
The conversation begins with Dr. Carvalho outlining the different types of defects, from minor issues, like a single tooth missing, to more severe cases, such as the loss of bone and soft tissue around implants. The key challenge in these cases is ensuring that the soft tissue around implants forms naturally, offering both aesthetic appeal and long-term stability.
Dr. Carvalho emphasizes the importance of collaboration between the prosthodontist and the periodontist throughout the process. He believes that this combined effort, where both disciplines work together during the planning and surgical stages, leads to the best results. For example, provisional restorations must be considered at the very beginning of the treatment, even before surgery, to shape the soft tissue around the future implant.
He also stresses the significance of soft tissue augmentation, noting that grafting techniques should be tailored to each patient’s needs. While bone augmentation is sometimes necessary, Dr. Carvalho prefers to use soft tissue grafts in many cases due to their predictability and lower invasiveness. He discusses how to address both horizontal and vertical soft tissue defects, showcasing real-world cases where grafts helped regenerate healthy, aesthetic tissue around implants.
Ultimately, Dr. Carvalho’s approach to treating soft tissue defects involves a careful balance between surgical precision and aesthetic goals, using a tailored, patient-centric approach that avoids unnecessary complexity while ensuring optimal results. His advice is a powerful reminder of the importance of thoughtful planning and collaboration in implant dentistry.