Edentulous site enhancement: a regenerative approach for the management of edentulous areas. Part 1. Pontic areas.

The successful esthetic integration of a prosthesis is dependent on the anatomic site in which the restoration is inserted. Edentulous site enhancement is a regenerative approach based on the following: (1) anatomic evidence that the morphology of soft tissues is dependent on the underlying support (bone, roots, implants) but also significantly influenced by overlying structures (fixed or removable prostheses); (2) histologic evidence of the remarkable regenerative capacity of the newly formed tissue that develops during healing by secondary intention; (3) clinical evidence that it is possible to guide the formation of this new regenerative tissue by creating a support with proper morphology and a highly polished surface; (4) observations that positive pressure exerted by alimentary bolus and negative pressure produced by deglutition affect the growth of this tissue healing by second intention; and (5) the application of appropriate oral hygiene techniques to guide tissue healing and maintain its integrity. The edentulous site enhancement approach is simple, practical, and predictable and offers minimal postoperative complications. This paper describes the edentulous site enhancement approach as applied in the pontic areas.