Factors Influencing the Presence of Papilla between Adjacent Implants and between a Tooth and an Implant

Abstract

Čimbenici koji utječu na prisutnost papile između susjednih implantata i između zuba i implantataUvod U dentalnoj medicini povećani estetski zahtjevi traže kao ideal konture mekoga tkiva s intaktnim papilama i simetričnim obrisom gingive (1). U idealnom slučaju uspješne implantoprotetičke restauracije izgledaju što je moguće sličnije prirodnim zubima (2). Boja, tekstura, visina i debljina periimplantatnog mekog tkiva najvažniji su u postizanju rezultata s restauracijama na implantatima (3).Uspješna oseointegracija implantata ne jamči zadovoljstvo pacijenata. Za njihovu percepciju uspješne restauracije presudno je zdravlje mekoga tkiva (4). Danas je kod pacijenata koji dolaze radi terapije sve veći naglasak na estetici osmijeha. Prisutnost ili odsutnost interproksimalne papile između susjednih zuba, između zuba i implantata ili između dvaju implantata snažno utječu na estetski ishod, što zahtijeva visoku razinu vještine i stručnog znanja kliničara kako bi očuvao papile u sklopu implantoprotetičke terapije (5 ).Papila je interproksimalni produžetak gingive, a njezina arhitektura povezana je sa stanjem kontaktne točke između Abstract Aim: The aim this study was to evaluate the factors that influence the presence or absence of the interproximal papilla between implants adjacent to the teeth or other implants, through clinical and radiographic evaluation. Material and Methods: The non-probabilistic sample comprised 44 patients of both genders aged between 21 and 68 years, rehabilitated with 114 osseointegrated implants. Through a retrospective clinical study, the patients were divided according to the presence or absence of the interproximal papilla: Group 1 -Absence of Papilla, Group 2 -Partial Presence of Papilla and Group 3 -Total Presence of Papilla. The success of the implants, the periodontal biotype, and the vertical and horizontal distances of the interproximal regions included in the study were evaluated. Results: Of the 114 implants, 46.5% were considered unsuccessful, and bleeding was present in 29.8%. The periodontal biotype presented as thin and scalloped was found in 85.1% of the regions. The evaluation of the groups according to the confirmation of the interproximal space showed a statistically significant difference (p = 0.007), with 61.9% of the wide and long interproximal spaces classified as Group 1, while 31% of the narrow and short interproximal spaces were classified as Group 3. Conclusion: It was concluded that the morphology of the interproximal space was the factor that was most strongly associated with the presence or absence of the interproximal papilla.

Two adjacent implant‐supported restorations in the aesthetic region: A 10‐year prospective case series

“…Roccuzzo and colleagues’ retrospective study 22 showed that this was not only the case at the final follow‐up evaluation, but also already at baseline. This finding is also in line with the Souza and colleagues study, which stated that none of the cases had perfect anatomical papilla between the two implant‐supported restorations 13 . The inter‐implant bone crest and horizontal inter‐implant distance is important for developing the inter‐implant papilla 35 .…”

“…This finding is also in line with the Souza and colleagues study, which stated that none of the cases had perfect anatomical papilla between the two implant-supported restorations. 13 The inter-implant bone crest and horizontal inter-implant distance is important for developing the inter-implant papilla. 35 Moreover, the inter-implant bone loss should be kept to a minimum to maintain the inter-implant papilla.…”

“…11,12 Souza and colleagues stated that, after a medium follow-up period, none of their cases had perfect anatomical papilla between the two implant-supported restorations. 13 Furthermore, the preoperative bone conditions in the maxillary aesthetic region are often poor for the adjacent implants, which means that the bone and soft tissues often have to be restored in three dimensions with augmentation procedures that brings extra uncertainties for achieving good aesthetic results. 14,15 Vigolo and colleagues reported a mean marginal bone loss of 0.8 ± 0.2 mm for unsplinted restorations in the maxilla after a 5-year follow-up period.…”

“…Furthermore, the presence of interproximal papilla between two adjacent implant restorations depends on the distance between the contact point to the bone crest, as well as the mesio‐distal distance between the implants 11,12 . Souza and colleagues stated that, after a medium follow‐up period, none of their cases had perfect anatomical papilla between the two implant‐supported restorations 13 . Furthermore, the preoperative bone conditions in the maxillary aesthetic region are often poor for the adjacent implants, which means that the bone and soft tissues often have to be restored in three dimensions with augmentation procedures that brings extra uncertainties for achieving good aesthetic results 14,15 .…”

Treatment of Early Developed Peri-Implantitis in Fibula Graft Site

“…Although early crestal bone loss may produce the environment that is favorable for anaerobic bacterial growth, especially in one phase implant placement technique as in this case, and thus possibly contribute to more bone destruction in following years, there has been no evidence in the literature that peri-implantitis induces crestal bone loss during the healing period and the first year after prosthetic loading at a faster rate than in the years to follow ( 10 , 11 ).…”