The pediculated connective tissue graft: a novel approach for the "blown-out'' site in the esthetic zone.

Management of the soft-tissue framework around an implant is key to achieving ideal esthetics in the maxillary anterior esthetic zone. When a patient has a tooth with advanced bone loss and recession in the esthetic zone, removing that tooth and replacing it with an implant often requires multiple surgical procedures to restore the lost hard and soft tissue. This article will discuss a novel approach to this dilemma, by means of a case treated with a single-stage surgical procedure using the pediculated connective tissue graft. The extraction of an anterior tooth with advanced bone loss, placement of an immediate implant, and reconstruction of the hard and soft tissue with one surgery will be demonstrated. Finally, the 2-year follow-up of the final prosthetic restoration that shows the stability of the soft tissue also will be presented.