{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:48:59Z","timestamp":1784288939204,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To develop a comprehensive decision\u2010making tree for evaluating mid\u2010facial peri\u2010implant soft tissue dehiscence in the esthetic zone and provide a systematic approach for assessing various clinical case scenarios, determining appropriate treatment strategies, and considering factors such as the need for soft tissue augmentation, prosthetic changes, or implant removal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Considerations<\/jats:title><jats:p>This clinical decision tree illustrates numerous case scenarios with various esthetic complications around an esthetically compromised, but clinically healthy single implant and provides clinicians with possible solutions as a predictable map for horizontal and vertical soft tissue augmentation in order to manage different clinical circumstances. According to current evidence, the key to treating such esthetic complications is the use of an adequate pre\u2010surgical prosthetic interdisciplinary approach with proper surgical techniques in order to optimize soft tissue dimensions and create better esthetic results. This may be accomplished through a purely surgical, combination of surgical and prosthetic, or purely prosthetic approaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present report describes a series of successfully treated peri\u2010implant esthetic complication cases in accordance with the decision\u2010making tree that the authors recommend in order to achieve better long\u2010term esthetic outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Significance<\/jats:title><jats:p>The combination of adequate pre\u2010surgical prosthetic interdisciplinary collaboration and proper surgical technique is critical in the optimization of sufficient soft tissue dimensions and contributes to a more highly esthetic result. This study demonstrates a clinical decision\u2010making tree to provide comprehensive, effective therapy of an esthetically compromised dental implant by using one of the following approaches: purely prosthetic, purely surgical, or a combination of surgical and prosthetic with or without abutment removal.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jerd.13100","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T11:20:21Z","timestamp":1689333621000},"page":"1239-1248","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["A decision\u2010making tree for evaluating an esthetically compromised single dental implant"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7437-6279","authenticated-orcid":false,"given":"Abdusalam","family":"Alrmali","sequence":"first","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"},{"name":"Department of Oral Pathology, Oral Medicine and Oral &amp; Maxillofacial Surgery University of Tripoli, School of Dentistry  Tripoli Libya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Stuhr","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad H. A.","family":"Saleh","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Latimer","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Kan","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics and Implant Surgery Loma Linda University School of Dentistry  Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis P.","family":"Tarnow","sequence":"additional","affiliation":[{"name":"Department of Periodontics Columbia University College of Dental Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4238-1799","authenticated-orcid":false,"given":"Hom\u2010Lay","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,14]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"9","article-title":"On crestal\/marginal bone loss around dental implants","volume":"33","author":"Albrektsson T","year":"2013","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12415"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.18-0616"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.11607\/jomi.2014suppl.g3.2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.19-0716"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.21-0402"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.13658"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17072281"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"216","DOI":"10.11607\/jomi.2013.g3","article-title":"Consensus statements and recommended clinical procedures regarding optimizing esthetic outcomes in implant dentistry","volume":"29","author":"Morton D","year":"2014","journal-title":"Int J Oral Maxillofac Implants"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.12928"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2015.130674"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12948"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.12487"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.20-0519"},{"key":"e_1_2_10_16_1","first-page":"2013","article-title":"Peri\u2010implant papilla reconstruction at an esthatically failing implant","volume":"40","author":"Stafinini M","year":"2020","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_2_10_17_1","first-page":"233","article-title":"Clinical decisions: determining when to save or remove an ailing implant","volume":"37","author":"Tarnow DP","year":"2016","journal-title":"Compend Contin Educ Dent"},{"key":"e_1_2_10_18_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_10_19_1","volume-title":"Evolution: Contemporary Protocols for Anterior Single\u2010Tooth Implants","author":"Gamborena IBM","year":"2014"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.19-0566"},{"key":"e_1_2_10_21_1","first-page":"416","article-title":"Implant associated soft tissue defects in the anterior maxilla: a randomized control trial comparing subepithelial connective tissue graft and acellular dermal matrix allograft","volume":"23","author":"Anderson LE","year":"2014","journal-title":"Implant Dent"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0501.2007.01497.x"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.13188"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.12853"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.2174"},{"key":"e_1_2_10_26_1","first-page":"281","article-title":"Implant esthetic complications: anatomical, prosthetic, and patient\u2010centered considerations for treatment","volume":"43","author":"Tavelli L","year":"2023","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/cre2.380"},{"key":"e_1_2_10_28_1","unstructured":"AlrmaliA SalehM GnaoH StuhrS RasperiniG WangHL.Three\u2010Dimensional Vertical Soft Tissue Augmentation of Esthetically Failing Permanent Submerged Dental Implant. Accepted IJOI\u20102023\u201027 \u2013 (2449)."},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-019-03127-0"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41432-020-0133-3"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.2817"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.2818"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41432-020-0138-y"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.12861"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.13920"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.13751"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12178"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12446"}],"container-title":["Journal of Esthetic and Restorative Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jerd.13100","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T11:57:57Z","timestamp":1700135877000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jerd.13100"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,14]]},"references-count":37,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1111\/jerd.13100"],"URL":"https:\/\/doi.org\/10.1111\/jerd.13100","archive":["Portico"],"relation":{},"ISSN":["1496-4155","1708-8240"],"issn-type":[{"value":"1496-4155","type":"print"},{"value":"1708-8240","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,14]]},"assertion":[{"value":"2023-05-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}