New Surgical Protocol to Create Interimplant Papilla: The Preliminary Results of a Case Series

Abstract

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Salvaging the Lost Pink Triangle: A Case Series of Papilla Reconstruction

“…The use of microsurgical approaches has also been used for papilla reconstruction which cause lesser trauma and better healing outcomes [4]. Similar techniques have been used to create interimplant papilla which include the use of connective tissue graft [6], PRF [29], autogenous bone, metal pins [30], modified instrument design by Froum et al [10], and papilla amplification flap [31].…”

“…Shapiro [18] Used periodic curettage of papilla to increase size of papilla 8 Evian et al [45] Modified the intact papilla technique 9 Takei et al [23] Papilla preservation technique and use of palatal semilunar incision 3 mm apical to gingival margin 10 Checchi and Schonfeld [13] Modified Evian and Takei's technique and suggested to give buccal incision and coronally advance it to cover graft in the palatal area. Lingual incision was to be given when maximum depth of defect was in labial aspect 11 Beagle [7] Combines principles of Abrams' roll technique for ridge augmentation with augmentation of Evian's papilla preservation technique.…”

“…McGuire and Scheyer [47] Augmentation of papilla by injecting autologous fibroblasts 21 Nordland and Sandhu [15] Microsurgical technique to augment papilla 22 Akiyama [48] Papilla reconstruction done using a microscope 23 Froum et al [10] New surgical technique for interimplant papilla reconstruction by giving oblique incisions in the vestibular area labially and palatally and creating a tunnel using translingual curette to advance the papillary unit…”

“…Papilla reconstruction or its augmentation is the most esthetically challenging procedure in perioplastic procedure [6]. A number of techniques have been developed by various authors such as Beagle [7], Azzi et al [8], Han and Takei [9], Carnio [6], and Froum et al [10] in an attempt to convert the black triangle into an aesthetic pink triangle. The methods include nonsurgical and surgical methods (Table 1).…”

Problem Solving Guidelines for Aesthetically Compromised Maxillary Anterior Implant Restorations

“…Several flap techniques have been proposed to recreate the missing papilla such as the palatal striding slip flap, U-shaped incision and Pallaci's 90 degree flap rotation. Froum and colleagues presented a technique to create a mucoperiosteal tunnel from the buccal to the palatal aspect of the deficient site and insert a connective tissue graft (Figures 7A-7D) [21]. The desired result of these surgical techniques is an increase in soft tissue thickness in the papillary region, which can then be sculpted by the provisional restoration.…”