Incomplete flap coverage or early exposure over implants and/or barrier membranes have a negative effect on bone regeneration. In cases of using regenerative techniques, complete soft tissue coverage of the implant area is necessary to promote adequate conditions for guided bone regeneration. Primary socket closure may be difficult, when periosteal releasing incision is only used, due to the opening left by extracted tooth. Therefore, Soft tissue grafting techniques are used to achieve primary soft tissue closure.

Soft tissue grafting techniques, with or without barrier membranes, were performed for primary closure in four cases of immediate placements. Three different methods were used (CTG, VIP-CT, Palatal advanced flap). Clinical results of the grafting were evaluated.

One case showed early exposure of cover-screw and, no other complications were noted. In the others, Primary closure was achieved by soft tissue grafting techniques. One of the cases, Graft showed partial necrosis, but there were no exposure over implants and/or barrier membranes.

The use of grafting techniques, in immediate implant placement, can predictably obtain primary closure of extraction sockets, thereby providing predictable bone formation and improved implant results.