{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:01:14Z","timestamp":1790269274492,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Adv Periodontics"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vertical implant soft tissue augmentation is indicated to optimize esthetic outcomes in cases of peri\u2010implant soft tissue deficiency or dehiscence, particularly when the peri\u2010implant mucosa is exposed during a full smile. This manuscript describes the use of a subperiosteal circumferential connective tissue graft (SC CTG) for vertical implant soft tissue augmentation via the vestibular incision subperiosteal tunnel access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 78\u2010year\u2010old Caucasian female presented with peri\u2010implant soft tissue deficiency at unrestored implants #7 and #8, with peri\u2010implant mucosal margins visible during a full smile. Vertical implant soft tissue augmentation using a SC CTG was performed initially on both implants #7 and #8, and on implant #8 alone 6 weeks later. Four weeks after the second augmentation, the implants were provisionalized, and definitive restorations were delivered 8 months thereafter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The peri\u2010implant mucosa at both implants appeared pink, firm, stippled, and well adapted to the restorations. Mucosal display at implants #7 and #8 during a full smile was comparable to and harmonious with the contralateral dentition. The patient reported satisfaction with the esthetic outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SC CTG, featuring perforations created with a tissue punch to permit passage of the healing abutments, enabled graft stabilization solely by the abutments and facilitated circumferential enhancement of the peri\u2010implant mucosal phenotype without the need for sutures when applied via the vestibular incision subperiosteal tunnel access. Within the limitations of this case report, this approach appears to be a simple, effective, and sutureless technique for vertical implant soft tissue augmentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>The subperiosteal circumferential connective tissue graft (SC CTG), featuring a tissue punch\u2010created perforation for healing abutment passage, enables graft stabilization by the abutment alone and facilitates circumferential enhancement of the peri\u2010implant mucosal phenotype.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>For optimal outcomes, the SC CTG should be stabilized with a narrow healing abutment or a restoration with narrow submucosal contours to maximize circumferential tissue gain and enhance peri\u2010implant tissue stability.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The thickness and dimensional stability of the SC CTG are key determinants of vertical soft tissue gain.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cap.70110","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:09:56Z","timestamp":1790266196000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Subperiosteal circumferential connective tissue graft for vertical implant soft tissue augmentation"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7525-7992","authenticated-orcid":false,"given":"Jonathan H.","family":"Do","sequence":"first","affiliation":[{"name":"Private Practice San Diego California USA"},{"name":"Former Assistant Clinical Professor of Periodontics UCLA School of Dentistry Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4921-5380","authenticated-orcid":false,"given":"Alex S.","family":"Kim","sequence":"additional","affiliation":[{"name":"Private Practice San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"62","article-title":"Prosthetic management of implants in the esthetic zone","volume":"19","author":"Higginbottom F","year":"2004","journal-title":"Int J Oral Maxillofac Implants"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022\u20103913(84)80097\u20109"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12220"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.18\u20100616"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.24\u20100119"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prosdent.2006.12.005"},{"issue":"9","key":"e_1_2_8_8_1","first-page":"719","article-title":"The pediculated connective tissue graft: a technique for improving unaesthetic implant restorations","volume":"14","author":"Mathews DP","year":"2002","journal-title":"Pract Proced Aesthet Dent"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.4296"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.13188"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.7619"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cap.10145"},{"issue":"6","key":"e_1_2_8_13_1","first-page":"665","article-title":"The connective tissue platform technique for soft tissue augmentation","volume":"32","author":"Zucchelli G","year":"2012","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.7286"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cap.70043"},{"issue":"6","key":"e_1_2_8_16_1","first-page":"653","article-title":"Minimally invasive treatment of maxillary anterior gingival recession defects by vestibular incision subperiosteal tunnel access and platelet\u2010derived growth factor BB","volume":"31","author":"Zadeh HH","year":"2011","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.13356"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752\u20101947\u20107\u2010223"},{"issue":"7","key":"e_1_2_8_19_1","first-page":"26","article-title":"Managing esthetic challenges with anterior implants. Part 1: midfacial recession defects from etiology to resolution","volume":"34","author":"Chu SJ","year":"2013","journal-title":"Compend Contin Educ Dent"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2015.150346"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.22\u20100493"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1973.44.12.727"}],"container-title":["Clinical Advances in Periodontics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cap.70110","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cap.70110","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cap.70110","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:09:57Z","timestamp":1790266197000},"score":1,"resource":{"primary":{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/10.1002\/cap.70110"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":21,"alternative-id":["10.1002\/cap.70110"],"URL":"https:\/\/doi.org\/10.1002\/cap.70110","archive":["Portico"],"relation":{},"ISSN":["2573-8046","2163-0097"],"issn-type":[{"value":"2573-8046","type":"print"},{"value":"2163-0097","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]},"assertion":[{"value":"2026-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"cap.70110"}}