Evaluation of the Effects of Buccal-Palatal Bone Width on the Incidence and Height of the Interproximal Papilla Between Adjacent Implants in Esthetic Areas

Abstract

Background: The presence of interproximal papilla depends on the distance between the contact point to the bone crest, as well as the mesio-distal distance between implants or between implants and teeth. The aim of this study is to evaluate the effects of buccal-palatal bone width on the presence of the interproximal papilla between adjacent implants in esthetic areas of the mouth. Methods: The presence or absence of the gingival papilla, distance from the base of the interproximal contact to the tip of the gingival papilla (black space), distance from the base of the interproximal contact to the alveolar crest (vertical distance), alveolar bone width (bone width) between adjacent implants as well as the spacing between the implants (horizontal distance), and soft-tissue biotype were assessed in 29 interimplant areas in the upper incisor, canine, and premolar regions of 18 patients. Results: The papilla was always present when vertical distance was <= 5 mm (P <= 0.04) and frequently present when the horizontal distance was >= 4 mm (P = 0.04). The black space was smaller when the vertical distance was <= 5 mm (P <= 0.04) and when the horizontal distance was >= 4 mm (P = 0.76). Bone width and soft-tissue biotype did not influence the incidence of gingival papilla (P >= 0.41) and black space (P >= 0.15). Conclusion: Within the limits of this study, it can be concluded that bone width and tissue biotype do not have an effect on the incidence and height of papilla between adjacent implants in esthetic areas, and the incidence was greater when vertical distance was <= 5 mm or when horizontal distance was >= 4 mm. J Periodontol 2013;84:170-175.