Implant-Supported Vertical Soft Tissue Augmentation for Severe Hard and Soft Tissue Deficiencies at Malpositioned Implants: A Case Report of a Mucogingival and Restorative Approach.

The management of severe mucogingival deformities surrounding malpositioned implants rep-resents a complex issue with a high risk of esthetic failure. The present case report describes a mucogingival and restorative approach for the treatment of severe localized peri-implant tissue defi-ciencies with interproximal bone loss combined with an interproximal gingival recession on the ad-jacent natural tooth. This approach consists of maintaining a nonrestorable malpositioned implant, submerging it through one or multiple vertical soft tissue augmentations according to the defect severity, and delivering a tooth-supported bridge involving the adjacent natural teeth. The step-by-step surgical technique adopted for implant submergence and vertical soft tissue grafting, as well as the subsequent surgical and prosthetic interventions, are described, presenting results at 5 years from implant submergence and 3 years from prosthetic finalization.