The “Tunneled Sandwich” Technique for Preserving the Buccal Tissue Volume After Immediate Implantation: A Retrospective Report of 10 Cases

The tooth loss or extraction is associated with significant diminishing the volume of alveolar ridge extensively expressed in the anterior zone. The immediate implant placement itself is considered inappropriate to overcome this problem. The proposed approach combined the technique of immediate implant placement with the enhancement of the buccal tissue by applying a cross-linked collagen matrix hydrated with a cross-linked hyaluronic acid. In a series of ten cases, all presenting with a retained but narrow buccal socket wall, an immediate implant placement along with the "tunneled sandwich" technique was performed following tooth extraction. The tunneled sandwich technique helped to create a subperiosteal pouch for insertion of the collagen matrix buccal to the alveolar bone crest. The implants healed transmucosally by receiving either a gingiva former or an immediate temporary restoration. Ten sites in ten patients demonstrated stable non-inflamed peri-implant conditions and suitable ridge volume at the implant's neck and achieved high pink esthetic scores estimated 6 months after implant loading. The "tunneled sandwich" technique appears a suitable method to preserve the buccal volume, which contributes as biologically as esthetically to favorable long-term results. Int J Periodontics Restorative Dent. 10.11607/prd.6205.