The Esthetic Buccal Flap for Alveolar Ridge Augmentation at the Time of Extraction in Complex Cases: A Case Report of Three Cases.

The esthetic buccal flap, which allows access to the apical area of a tooth or extraction socket via a submarginal incision, was initially introduced for buccal fenestration defects correction during immediate implant placement. This case report describes its expanded use for ridge augmentation at the time of extraction when immediate implant placement is not indicated. The esthetic buccal flap was used for ridge augmentation in three patients with significant maxillary anterior hard tissue defects. At the time of implant placement, which was delayed five to six months, soft tissue augmentation was performed to enhance esthetic outcomes. After provisionalization, final restorations were delivered, and esthetics were assessed using the modified Pink Esthetic Score (mPES). All three cases obtained mPES scores of 9 or 10, which indicates excellent soft tissue contour, symmetry, and integration. Within the limitations of this case report, these results indicate that the esthetic buccal flap is a minimally invasive, soft tissue preserving technique that can be adapted to treat complex alveolar ridge defects. In combination with newer biomaterials and the use of a delayed implant procedure, this strategy provides predictable results for regenerative as well as esthetic success in difficult anterior cases.