You Can’t Graft Your Way Out of a Prosthetic Problem
Prosthetic-surgical treatment of peri-implant soft tissue deficiencies — classify honestly, reshape the restoration, then graft.
By Dr. Jonathan Misch, DDS, MS · Aug 24, 2026 · 9 min read
An apically positioned margin with the collar showing through — and the same site after the staged prosthetic-surgical sequence
A patient points at a grey shadow above an anterior implant crown and asks what happened. The reflex is to book a connective tissue graft. That reflex is where most of these cases are lost — not because grafting is wrong, but because a coronally advanced flap has nothing to advance over when the crown …
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