Disparity in embrasure fill and papilla height between tooth‐ and implant‐borne fixed restorations in the anterior maxilla: a cross‐sectional study

Abstract

Disparity in embrasure fill and papilla height between tooth-and implant-borne fixed restorations in the anterior maxilla: a cross-sectional study AbstractPurpose: The objective of the present study was to compare inter-proximal fill and papilla height between different embrasures. Material & Methods: One hundred and fifty non-smoking consecutive patients (mean age 54, range 32-73; 63 males and 87 females) without periodontal disease were selected in a multidisciplinary practice during regular supportive care. All had been treated for multiple tooth loss in the anterior maxilla at least 1 year earlier by means of a fixed restoration on teeth (n = 50) or implants (n = 100) using straightforward procedures (without hard and/or soft tissue augmentation). Embrasure fill was assessed by means of Jemt's papilla index and papilla height was registered following local anaesthesia by means of bone sounding by one clinician. Results: Tooth-pontic and tooth-implant embrasures demonstrated comparable inter-proximal fill and papilla height ( 58% Jemt's score 3; mean papilla height 4.1 mm). Between missing teeth, embrasure fill and papilla height were lower regardless of the embrasure type. The implant-implant and implant-pontic embrasure demonstrated comparable outcome ( 42% Jemt's score 3; mean papilla height 3.3 mm; p 0.416), which was significantly poorer when compared to the pontic-pontic embrasure (82% Jemt's score 3; mean papilla height 3.7 mm; p 0.019). Overall, papilla index and papilla height demonstrated a weak correlation (Spearman's correlation coefficient: 0.198; p = 0.002). Conclusions: The re-establishment of a papilla is difficult when there is no tooth involved. In that scenario a short papilla should be expected and implant-borne restorations demonstrate the poorest outcome. Moreover, an implant with a pontic may not perform better than adjacent implants.

Rehabilitation of the severely atrophied dentoalveolar ridge in the aesthetic region with corticocancellous grafts from the iliac crest and dental implants

“…The PES was >8 in all implants with adjacent teeth on both sides. These findings are in line with the literature showing that the re-establishment of soft tissue and papilla height is difficult and pontic may not perform better than adjacent implants (25). …”

“…This is correlating to the amount and nutrition of the bone between the implants as earlier shown (25), since two adjacent implants needs more “interdental space” than an implant and a tooth. The distance from the bone level to the approximal contact is critical for optimal papilla formation and the design of the implant crown and the crown of the adjacent teeth are of big importance (27).…”

“…With two or more adjacent implants, the formation of the papilla is more demanding to achieve than with a tooth next to the implant crown. In a study by Cosyn and co-workers 2013 (25) the embrasure and papilla heights between tooth-implant and implant-implant interfaces were measured. They found that between implants the papilla height is almost one mm shorter than with a tooth adjacent to the implant (4.1mm compared to 3.3mm).…”

Reduction of Gingival Black Triangles with Dental Pulp or Gingival Stem Cell Injection Therapy: Clinical and Outcomes Research Gaps

“…For example, careful positioning of veneers or crowns is important to avoid problems with bite or decay around the edges, a concern not applicable with stem cell treatment. Restorations for implants may not be as successful as teeth [17], whereas no such concern is relevant for GBT treatment with stem cells. Further, stem cell treatment may be appropriate for a broader patient population; for example, patients who grind their teeth are not good candidates for porcelain veneers or implants yet stem cell treatment would not be contraindicated.…”

Etiology and classification of food impaction around implants and implant‐retained prosthesis

“…Factors such as loss of proximal contact, altered morphology of the implant prosthesis, mesial or vertical migration of the adjacent tooth, incomplete or lack of papillary fill between the implant and adjacent teeth or between two implants, abnormal occlusal load, etc. alter the morphology of the embrasures and increase the risk of food impaction around implant/implant‐retained prosthesis . Although clinicians do acknowledge the presence of food impaction around implants, no classification system has yet aimed to categorize the type and etiology for food impaction around implant/implant‐retained prosthesis.…”