Soft Tissue Thickening Around Dental Implants Using a Tent-Pole Approach: A Clinical Case with Quantitative Evaluation

Abstract

The thickness of the soft tissue surrounding the implant and the height of the supracrestal tissue play a significant role in maintaining biological stability. It has been reported that insufficient tissue dimensions may adversely affect the peri-implant mucosal barrier, leading to early crestal bone remodeling. The tentpole approach is a surgical technique designed to support soft tissue during the healing process. This study evaluates the effects of this technique on peri-implant soft tissue thickness and early stage alveolar bone levels. This retrospective case series included 14 consecutive patients with mandibular partial edentulism who underwent the tent-pole technique. All surgical procedures were performed according to a standard clinical protocol. Peri-implant soft tissue thickness and alveolar bone levels were assessed at three time points: implant placement time (T0), two-month control (T1), and four-month follow-up (T2). Soft tissue measurements were performed using digital image analysis from standardized clinical photographs and measured using ImageJ software. Changes between time points were analyzed using the Friedman test and the Wilcoxon signed-rank test. In patient-based analyses, peri-implant soft tissue thickness was measured as a median of 1.97 mm (Q1–Q3: 1.79–2.06) at T0, 3.18 mm (2.96–3.53) at T1, and 3.13 mm (3.00–3.45) at T2. Statistically significant increases were observed in the T0–T1 and T0–T2 comparisons (p < 0.001), while no significant difference was found between the T1–T2 time points (p = 0.583). No statistically significant change was detected in alveolar bone level measurements between the T0, T1, and T2 time points (p > 0.05). In this case series, peri-implant soft tissue thickness increased significantly following application of the tent-pole technique. However, no significant change in alveolar bone levels was observed in the early period. These findings suggest that the tent-pole approach may be a potential surgical method to support peri-implant soft tissue stability. However, larger-scale, controlled clinical studies are required to evaluate the long-term clinical effects of this technique.