Mind the Gap-Soft Tissue Loss around 8/9 implants
This is a 38 y/o male, no medical contraindications. He came to us this morning for a second opinion on what can be done for the loss of the interdental papilla between 8 and 9. According to him, he had bone grafting after trauma, and implants were placed 2013.Space has developed in the past few years. He wants to know what can be done. His smile line stops right at the apical of the contact point between 8 and 9. IHB to contact area is about 5mm.
Some options that come to mind
1) Autogenous CTG first, then possibly some veneer bone grafting around 8 and 9.
2) Remove prosthesis, place cover screws on 7,8,9 and use nature's soft tissue graft first by letting
gingiva close, then use "guided" tissue regeneration with narrow healing abutments on 7,8,9 with a soft tissue graft, have patient in essix appliance.
3) Do nothing
Anything obvious I might be overlooking? Other options come to mind? Thanks