Clinical and radiographic evaluation of the papilla level adjacent to single-tooth dental implants. A retrospective study in the maxillary anterior region

Background: The regeneration of gingival papillae after single-implant trea tment is an area of current investigation. This study was designed to deter mine: 1) whether the distance from the base of the contact point to the cre st of the bone would correlate with the presence or absence of interproxima l papillae adjacent to single-tooth implants, and 2) whether the surgical t echnique at uncovering influences the outcome. Methods: A clinical and radiographic retrospective evaluation of the papill a level around single dental implants and their adjacent teeth was performe d in the anterior maxilla in 26 patients restored with 27 implants. Six mon ths after insertion, 17 implants were uncovered with a standard technique, while 10 implants were uncovered with a technique designed to generate papi lla-like formation around dental implants. Fifty-two papillae were availabl e for clinical and radiographic evaluation. The presence or absence of papi llae was determined, and the effects of the following variables were analyz ed: the influence of the 2 surgical techniques; the vertical relation betwe en the papilla height and the crest of bone between the implant and adjacen t teeth; the vertical relation between the papilla level and the contact po int between the crowns of the teeth and the implant; and the distance from the contact point to the crest of bone. Results: When the measurement from the contact point to the crest of bone w as 5 mm or less, the papilla was present almost 100% of the time. When the distance was greater than or equal to6 mm, the papilla was present 50% of t he time or less. The mean distance between the crest of bone and the most c oronal papilla level (interproximal soft tissue height) was 3.85 mm (SD = 1 .04). When comparing the conventional and modified surgical technique, the relation shifted from 3.77 mm (SD = 1.01) to 4.01 mm (SD = 1.10), respectiv ely. Conclusions: These results clearly show the influence of the bone crest on the presence or absence of papillae between implants and adjacent teeth. Th e data also show a positive influence for the modified surgical technique, aimed at reconstructing papillae at the implant uncovering.