02/17/2026
A full-arch FP1 prosthesis requires ideal bone volume, precise implant positioning, controlled occlusion, minimal cantilever, and stable peri-implant soft tissue architecture. As no artificial gingiva is incorporated to compensate for tissue deficiencies, both biomechanical accuracy and meticulous hard and soft tissue management are critical for long-term success.
Adequate bone support, particularly a minimum of 2 mm buccal bone thickness with an intact facial plate, is essential to minimize facial bone resorption and prevent soft tissue recession. Preservation of this buccal plate is fundamental to maintaining gingival contours and esthetic outcomes. Furthermore, maintenance of peri-implant biologic width is crucial for tissue stability. Approximately 3–4 mm of vertical soft tissue dimension is required to establish a stable epithelial and connective tissue attachment around implants.
A minimum width of 2 mm of keratinized mucosa is preferred to facilitate effective plaque control, enhance patient comfort, and reduce peri-implant inflammation. In cases of soft tissue deficiency, augmentation procedures may be indicated. In the present case, soft tissue augmentation was performed using a vertical interpositional periosteal connective tissue (VIP-CT) flap for the upper tilted implants and a connective tissue graft (CTG) for the lower tilted implants to improve peri-implant tissue thickness and ensure long-term stability.
