A Modified Approach to Horizontal Augmention of Soft Tissue Around the Implant: Omega Roll Envelope Flap. Description of Surgical Technique

Clin Ter. Jul-Aug 2018;169(4):e165-e169. doi: 10.7417/T.2018.2073.


Objective: The flap's design, as applied to implant surgery procedures for implant-prosthetic therapy, takes inspiration from the roll technique of Abrams (1980) and subsequent modifications. This article describes a modified flap design for the correction of horizontal alveolar mucosa defects in implant-supported rehabilitation with one-stage and two-stage approache. The omega roll envelope flap (OREF) is a roll flap combined with a modified pouch technique. The goal of this type of flap design is to correct localized horizontal alveolar ridge defects and augment peri-implant soft tissue thickness.

Design: OREF is a flap technique that avoids harvesting autologous connective tissue from another donor site by using the supracrestal connective tissue of the implant surgical site. The proposed technique allows for increased horizontal buccal soft tissue thickness during implant-prosthetic rehabilitation.

Discussion: The OREF technique is practical for one- and two-stage implant approaches, and when it is applied with an immediate non-functional loading procedure, this technique can optimize surgical and prosthesis chair times. This technique has shown advantages as maximizes the amount of connective tissue that can be rolled within the buccal flap. The OREF technique can be applied with a one-technique can be applied with a one-stage or two-stage implant-prosthetic approach.

Keywords: Dental implant; Surgical flap; Wound healing.

MeSH terms

  • Connective Tissue / transplantation*
  • Dental Implantation, Endosseous / methods*
  • Dental Implants*
  • Gingiva*
  • Gingivoplasty / methods
  • Humans
  • Surgical Flaps


  • Dental Implants