# Modified Roll Flap Soft-Tissue Augmentation at Single-Stage Implant Placement: A Digital-Scan–Verified Case Report

## TL;DR

A modified roll flap technique was used with implant placement to improve soft-tissue thickness and achieve stable esthetics without bone grafts.

## Contribution

A modified pedicled roll flap technique is introduced for soft-tissue augmentation during single-stage implant placement.

## Key findings

- Soft-tissue thickness increased and remained stable over 14 months without bone substitutes.
- Keratinized mucosa was preserved and midfacial levels remained stable.
- Digital scans confirmed long-term maintenance of soft-tissue thickness.

## Abstract

Background and Objectives: Adequate peri-implant soft tissue dimensions are essential for health, hygiene, and esthetics. When ridge volume is sufficient, phenotype modification may avoid bone grafting. This case report describes a pedicled roll flap performed concurrently with single-stage implant placement after spontaneous socket healing, without bone substitute, and assesses soft-tissue stability with serial intraoral scans. Clinical case: A single-tooth edentulous site underwent prosthetically driven, fully guided implant placement. A modified roll flap with vertical and palatal incisions was prepared; the de-epithelialized crestal connective tissue was elevated and rolled into a buccal envelope to augment thickness. No graft material was used. A provisional crown conditioned the emergence profile. Follow-up included photographs, radiographs, and intraoral scan superimpositions at 2 weeks, 3–4 months, 8 months, and 14 months after implant treatment. Healing was uneventful. Buccal soft-tissue thickness increased, keratinized mucosa was preserved, and midfacial levels remained stable. Emergence profile and papillae integrated harmoniously. Crestal bone levels were stable radiographically. Digital scans corroborated soft-tissue thickness maintenance. No donor-site morbidity occurred. Conclusions: In healed sockets with adequate bone, a modified pedicled roll flap at implant placement can thicken the peri-implant phenotype and achieve stable esthetic integration without bone substitutes.