Soft Tissue Incision
Several types of incisions can be used to gain access to the residual ridge for implant placement. The incision should be designed to allow convenient retraction of the soft tissue for unimpeded implant placement. It should preserve or increase the quantity of attached tissue and preserve local soft tissue esthetics. When the quantity of attached tissue is adequate and the underlying bone is expected to he of adequate width,
a simple crestal incision is the incision of choice (fig. 14-45). Closure of the incision must be done carefully, hecause the implants lie directly beneath the incision.This approach works well in the mandible and posterior maxilla. An incision placed, slightly palatal Illay be a bet- (
ter .choic in the anterior maxilla, especially when esthetics is of concern, because it preserves facial contour and soft tissue bulk. When there has been loss of vestibular depth and Of attached tissue in the edentuious mandible, periirnplant soft tissue health is more likely if the tissue adjacent
to the implant is nonmobile. A modification of the Kazanjian vestibuloplasty can be used to gain access to the ridge for implant placement and to increase vestibular depth and quantity of attached issue on the residual ridgeJfig. 14-46).