{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:55:27Z","timestamp":1787064927614,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T00:00:00Z","timestamp":1554336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Successful immediate implant placement in the maxillary anterior zone continues to be a challenge. There is an uncertainty on whether it should be performed on patients with thin gingival phenotype or incomplete buccal plate. This clinical case report describes a novel technique for immediate implant placement with simultaneous hard and soft tissue augmentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical considerations<\/jats:title>\n                    <jats:p>This technique employs a combined epithelialized\u2010subepithelialized connective tissue graft and cortical\u2010cancellous autogenous bone graft for the treatment of incomplete buccal plate at an extraction site. Significant horizontal bone regeneration appears to have been achieved as well as soft tissue augmentation for a central incisor in a single surgical step. Following three and a half years, gingival contours and bone augmentation were stable with a pleasant esthetic result.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of the four\u2010layer tissue graft for immediate implant placement can be suggested to improve hard and soft tissues in a single procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical significance<\/jats:title>\n                    <jats:p>The use of the four\u2010layer graft technique has shown to be successful regarding function and esthetic outcomes in anterior immediate implant placement. It reduces surgical interventions and treatment time and minimizes soft tissue recession and bone resorption.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jerd.12480","type":"journal-article","created":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T09:34:25Z","timestamp":1554370465000},"page":"304-310","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The four\u2010layer graft technique, a hard and soft tissue graft from the tuberosity in one piece"],"prefix":"10.1111","volume":"31","author":[{"given":"Juan","family":"Zuf\u00eda","sequence":"first","affiliation":[{"name":"Department of general dentistry Private Practice  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2253-3927","authenticated-orcid":false,"given":"Gonzalo","family":"Blasi","sequence":"additional","affiliation":[{"name":"Division of Periodontology University of Maryland School of Dentistry  Baltimore Maryland"},{"name":"Department of Periodontics Universitat Internacional de Catalunya  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram\u00f3n","family":"G\u00f3mez\u2010Meda","sequence":"additional","affiliation":[{"name":"Department of general dentistry Private Practice  Le\u00f3n Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro","family":"Blasi","sequence":"additional","affiliation":[{"name":"Department of Restorative Sciences Dental College of Georgia, Augusta University  Augusta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2013.130064"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2005.00642.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2004.00565.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12571"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12666"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2016.160276"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.12347"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.3467"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.12896"},{"key":"e_1_2_7_11_1","first-page":"427","article-title":"Peri\u2010implant tissue response following 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width changes when placing implants at the time of tooth extraction with and without soft tissue augmentation after a healing period of 6 months: report of 24 consecutive cases","volume":"31","author":"Grunder U","year":"2011","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1902\/annals.2000.5.1.119"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpor.2018.07.003"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.2381"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.14436\/2237-650X.8.2.080-089.oar"},{"key":"e_1_2_7_24_1","first-page":"375","article-title":"Use of a combination epithelized\u2010subepithelial connective tissue graft for closure and soft tissue augmentation of an extraction site following ridge preservation or implant placement: description of a technique","volume":"30","author":"Stimmelmayr M","year":"2010","journal-title":"Int J 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