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Interproximal papillae reconstruction in maxillary implants
C E Nemcovsky1, O Moses, Z Artzi
1Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel. carlos@post.tau.ac.il
Background:
Gingival esthetics has become an important factor in the overall success of most maxillary implant-supported restorations. Periodontal plastic surgery procedures may be used to enhance esthetics in the maxillary anterior region. The purpose of the present study was to evaluate a new surgical approach, performed at implant exposure, to reconstruct interdental papillae around maxillary implant-supported restorations.
Methods:
The surgical procedure was performed on 32 patients, in which 36 consecutive single tooth osseointegrated implants were exposed in the anterior and premolar maxillary region. Previous to implant exposure and 6 months postoperatively, once the implant-supported restoration was in place, mesial and distal papilla contour measurements were calculated, based on a modification of the papillary index score (PIS). Statistical analysis consisted of paired t test, Pearson's correlation, and ANOVA with repeated measures.
Results:
Preoperative PIS ranged from 0 to 3 and from 1 to 3 at the 6 months follow-up control. A mean of mesial and distal papilla, within the same tooth, was used for paired t test statistical analysis. A mean increase of 1.07 (SD 0.43) in PIS was statistically significant (P<0.001). At the second measurement, in no site was PIS smaller (0%) while in 64 sites PIS was higher (89%). In 51 papilla (71%) there was an increase of 1 PIS unit and 13 (18%) of 2 PIS units between both measurements.
Conclusions:
The presented surgical technique performed at second stage implant surgery was useful for partial or total interproximal papilla reconstruction adjacent to maxillary single-implant restorations.