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Updated: Feb 15, 2026

Denver Papillae Protocol for Objective Analysis of Fungiform Papillae
Published on: June 8, 2015
Papilla-Crown Height Dimensions around Zirconium Dioxide Implants in the Esthetic Area: A 3-Year Follow-Up Study
Kim Kniha1, Karl Andreas Schlegel1, Heinz Kniha2
1Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany.
Purpose:
Soft tissue interactions with ceramic dental implants have previously been shown to have favorable esthetic outcomes. This study aimed to evaluate the papilla-crown proportion around zirconia implants in a 3-year follow-up study and the correlation between the gingival biotype and changes in papillary height.
Materials And Methods:
This was a prospective study of 39 patients with 40 single-gap implants (Straumann PURE Ceramic ZLA Implant). The papilla-crown proportion was assessed after 3 months, 1 year, and 3 years. In addition, correlations between the peri-implant biotypes and changes in papillary heights were evaluated.
Results:
The papilla-crown proportion improved from 35.5% after 3 months to 41.7% after 3 years. The gingival biotype was correlated very weakly to papilla height alterations. Significant papillary fill was observed in the interdental space between 3 months and 3 years (p < 0.001).
Conclusions:
An ideal papilla-crown proportion of 40% around single implants was observed after 3 years. A thin or thick gingival biotype showed a very weak correlation with soft tissue alterations.
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