Stepwise enhancement of peri-implant hard and soft tissue stability using UV photofunctionalization and a tuberosity free gingival graft: a case report

This case report presents a stepwise approach for improving the peri-implant tissue stability in the posterior maxilla using ultraviolet (UV) photofunctionalization and a non-de-epithelialized free gingival graft (FGG) from the maxillary tuberosity. Two implants were placed at the maxillary molar of a 69-year-old male. Intraoperative testing revealed poor wettability on the #26 fixture, which was subsequently enhanced with a UV treatment, whereas the moderately hydrophilic #27 fixture was placed untreated. Four months postoperatively, cone-beam computed tomography (CBCT) revealed favorable bone regeneration around the UV-treated. At the second-stage surgery, a tuberosity FGG was used to successfully augment a buccal soft tissue deficiency at the #26 site. This case highlights a predictable approach. An intraoperative hydrophilicity assessment can guide the selective use of UV photofunctionalization to promote osseointegration, while a tuberosity FGG offers a simple method to augment soft tissue and improve long-term stability in complex cases.