The document describes a case report of placing a 3.4mm implant in the upper jaw without sutures using Flex Barrier, a crosslinked hyaluronic acid membrane. Flex Barrier stabilized the soft tissue around the gingival former immediately, preventing the need for sutures. The case report shows that Flex Barrier allows for fast wound closure and good handling during application and injection into soft tissue. It also results in voluminous soft tissue and naturally looking papillae without additional surgery.

1. Case Report: „TFT“ Method (Tissue-Frame-Technique)
Implantology, sutureless
Surgeon: Michael Claar DDS, Kassel, Germany
Situation: Placement of a 3.4 mm Implant
Upper jaw
Front tooth
Material: Flex Barrier (crosslinked Hyaluronic acid)
Medical Instinct/ BoneTrust +
Summary:
To prevent the natural esthetic look of the mucosa, the soft tissue
around the Gingival Former is stabilized immediately without a suture
even by application of Flex Barrier. The case report shows, that the
aim of a voluminous soft tissue and naturally looking papillae is easily
to reach without any additional surgical procedures.
Flex Barrier warrants a fast wound closure and a good handling even
by application and injection into the soft tissue.

2. Ausgangssituation
Initial situation
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

3. Fehlender oberer, seitlicher Schneidezahn
Missing upper lateral incisor
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

4. Eröffnung ohne laterale Entlastungsschnitte
Incision witout lateral relief cut
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

5. Einbringung des 3,4 mm BoneTrust+ Implantates
Insertion of a 3.4 mm BoneTrust+ implant
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

6. Implantatverschluss mit Gingivaformer
Coverage of the implant with a gingival former
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

7. Wundverschluss durch Flex Barrier Membran ohne Naht
Wound closure with Flex Barrier without suture
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

8. Hydrophiles Flex Barrier „zieht“ das Defektblut in die Gelmatrix zur schnellen Koagulation
Flex Barrier is tracking the blood from the operating site for coagulation due to its hydrophil
characteristics
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

9. Vollständig abgeheilte, narbenfreie Weichgewebssituation nach einigen Wochen
Fully healed mucosa free of scares after a couple of weeks
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

10. Gesundes Weichgewebe nach Eröffnung
Healthy soft tissue after reopening
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

11. Ausreichende Weichgewebshöhe für eine natürliche und ästhtetische Prothtetik
Good height of soft tissue for natural and estheticly looking prosthtetics
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

12. Abformung mit der Repositionstechnik
Impression taking with the open tray technique
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

13. Zirkonabutment zur optimalen prothetischen Versorgung
Cercon Abutment for a optimum of prosthetetic solution
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

14. Krone unmittelbar nach der Eingliederung
Ceramic crown directly after integration
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

15. Finale Situation mit sehr guten Weichgewebsverhältnissen
Final situation with perfect soft tissue relation
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany

16. Röntgenkontrolle zeigt trotz offener Einheilung ohne Naht keinerlei Verlust des marginalen
Knochens
X-Ray shows no marginal bone loss particularly after wound healing without suture
Chirurg/Surgeon: Dr. Michael Claar/Kassel/Germany