Papilla Enhancement with Connective Tissue Grafts in Complex Aesthetic Cases
Free access
Evidence-based protocols
Real clinical case walkthrough
Learn the pros and cons of tunnel approach, CTG positioning, and staged protocols in an open video lesson from Dr. Damir Mukhamadiev
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The Case That Changed Everything
Challenge: Collapsed papilla in the most visible aesthetic zone
Constraint: Partial treatment only (financial limitations)
Diagnosis: Chronic periodontitis affecting all teeth
Patient: 38-year-old female | High smile line
Case Snapshot:
What Makes This Case Special:
The Impossible Request:
This isn't about maintaining soft tissue - it's about improving papilla height in a compromised surgical field. The kind of case most surgeons would avoid.
She wanted to keep her teeth as long as possible, refused full extraction, but demanded a perfect smile with beautiful gums.
✓ Strategic 6-12 month healing protocol
✓ Tunnel approach without vertical incisions
✓ Multiple CTG harvesting from tuberosity
✓ Staged implant placement strategy
The Approach:
The Result:
Not just functional implants. Not just maintained tissue. But demonstrable papilla enhancement that exceeded patient expectations.
In 25+ years of practice, I've performed over 1,500 soft tissue augmentations using various methods and I'm sharing this experience with you
WHAT YOU'LL LEARN FROM THE VIDEO LESSON?
Strategic staged implant placement: which factors influenced my choice to use a conservative approach vs. immediate loading in this complex case
04
The 6-12 month papilla maturation timeline and why rushing to final prosthetics destroys your aesthetic results
05
Proper CTG fixation protocol with 3-4 knots and how improper fixation leads to graft failure and necrosis
03
The tunnel approach technique: why positioning CTG between periosteum and mucosa (not split mucosa) prevents necrosis
02
How to achieve papilla improvement (not just to maintain it in the same condition) between implants and natural teeth in high smile line patients
01
Dr. Damir Mukhamadiev
Dr.Med.Dent, Master of Science, DICOI, EAO
When it comes to complex soft tissue management in the aesthetic zone, Dr. Mukhamadiev doesn't just teach theory - he shares battle-tested protocols from 25 years in the surgical chair.
- Global Educator
International speaker who has trained 3,000+ dentists worldwide in advanced implantology and augmentation techniques
- International Authority
Licensed consultant with Dubai Health Authority and CMC Dental Centre
- Premium Practice Owner
Founder of "Academia" - Moscow's leading premium implantology clinic
- 25 Years of Clinical Mastery
Performed over 1,500 soft tissue augmentation procedures across diverse clinical scenarios
- Academic Excellence
Research Supervisor for Master of Oral Implantology program at Frankfurt University
© 2025 Mukhamadiev Damir Mirgasimovich
Dubai Health Authority License: 784197684384866
Dubai Health Authority License: 784197684384866
All rights reserved.
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