case_images: PMC5660301_01
case_images: Pre operative
case_images: PAMJ-27-256-g001.jpg
case_images: PMC5660301_01_PAMJ-27-256-g001.jpg
case_images: f0001
case_images: In the fourth quadrant there was attached gingiva of about 3mm present on mesial implant but the distal implant showed less < 2mm of width of attached gingiva (Figure 1).
case_images: PRF membranes secured with sling sutures
case_images: PAMJ-27-256-g002.jpg
case_images: PMC5660301_01_PAMJ-27-256-g002.jpg
case_images: f0002
case_images: The 2 PRF membrane's are placed over lapping each other to cover all the three implants and are secured around the gingival former with the help of sling sutures (Figure 2).
case_images: Vestibuloplasty with PRF membrane in 3rd quadrant
case_images: PAMJ-27-256-g003.jpg
case_images: PMC5660301_01_PAMJ-27-256-g003.jpg
case_images: f0003
case_images: The coronal end of the partial thickness flap is positioned apically and sutured along with the apical end of the PRF membrane, to the underlying periostium, using 4-0 silk (Figure 3) (vestibuloplasty with PRF membrane).
case_images: Vestibuloplasty with PRF membrane in 4th quadrant
case_images: PAMJ-27-256-g004.jpg
case_images: PMC5660301_01_PAMJ-27-256-g004.jpg
case_images: f0004
case_images: PRF membrane was then placed over the exposed connective tissue bed and secured around the gingival former with stabilizing suture and sling suture respectively (Figure 4) (vestibuloplasty with PRF membrane).
case_images: Day 1 after surgery, PRF membrane whitish in colour
case_images: PAMJ-27-256-g005.jpg
case_images: PMC5660301_01_PAMJ-27-256-g005.jpg
case_images: f0005
case_images: In both the quadrants, on day 1 after the surgery, the surface of the PRF membrane appeared whitish in colour (Figure 5) but by day 8, neo-angiogenesis had set it and many new immature blood vessels were seen (Figure 6).
case_images: After 8 days, new immature blood vessels seen
case_images: PAMJ-27-256-g006.jpg
case_images: PMC5660301_01_PAMJ-27-256-g006.jpg
case_images: f0006
case_images: In both the quadrants, on day 1 after the surgery, the surface of the PRF membrane appeared whitish in colour (Figure 5) but by day 8, neo-angiogenesis had set it and many new immature blood vessels were seen (Figure 6).
case_images: After 4 week, sufficient coverage of exposed implant surface
case_images: PAMJ-27-256-g007.jpg
case_images: PMC5660301_01_PAMJ-27-256-g007.jpg
case_images: f0007
case_images: By the end of 4 weeks (Figure 7) the change in the tissue biotype from thin to thick, sufficient coverage of the exposed implant surfaces was achieved, there was evident increase in the vestibular depth and on pulling of the lower lips, no blanching of the marginal gingiva was visible.