Star-shaped incision technique for gingiva patients treated with implant-supported fixed prosthesis

To evaluate the modified star-shaped incision on gingival sulcus for reducing horizontal food impaction around implant-supported restoration. Total 24 patients receiving bone-level implant placement were enrolled, a star-shaped incision was made on the gingiva sulcus before the placement of zirconia crown. Follow-up examination was carried out 3 and 6 months after final restoration, respectively. Assessment of soft tissue includes papilla height, modified plaque index, modified sulcus bleeding index, periodontal depth, gingival biotype and gingival margin level. Marginal bone level was measured on periapical radiographs. Only 1 patient complained about the horizontal food impaction. Both the mesial and distal papilla almost filled the entire proximal space, in good harmony with the adjacent papillae. No recession of the gingival margin was found around the crown even in the patients with thin gingival biotype. Other parameters of soft tissue including modified plaque index, modified sulcus bleeding index and periodontal depth remained low during the whole follow-up visit. The resorption of marginal crestal bone was less than 0.6 mm during the first 6 month, and there was no significant difference among baseline, 3-month and 6-month visit. The modified star-shaped incision on the gingiva sulcus maintained the gingival papilla height and reduced the occurrence of horizontal food impaction, and no recession of the gingiva margin was found around implant-supported restoration.