Evaluation of the Presence or Absence of Papilla between Tooth and Implant

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

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.

Implant placement for patients with cleft lip and palate: A clinical report and guidelines for treatment

The multidisciplinary teams involved in the treatment of individuals with cleft lip and palate are challenged when implants are indicated in the cleft area. Difficulties include obtaining a healthy peri-implant area and, especially, obtaining the natural-looking papilla essential for esthetic success. The area affected by the cleft has a bone deficiency, which is typically augmented with an alveolar bone graft at adolescence. Guidelines for the 3-dimensional placement of implants at the cleft area are presented based on clinical reports. The patients were followed up for at least 1 year. Adoption of the proposed guidelines enables satisfactory esthetic and functional outcomes in patients with cleft lip and palate.

Technical and biological complications related to crown to implant ratio: a systematic review

AIM

To review the occurrence of prosthetic failure and biological complications with respect to the crown to implant (C/I) ratio.

METHODS

Accurate search was made on the subject C/I ratio with the following criteria: (1) studies on humans with data on prosthetic failure and/or biological complications related to C/I ratio; (2) partial edentulous patients; (3) randomized clinical trials, prospective, longitudinal, retrospective, and multicenter studies with a minimum of 48 months mean follow-up; (4) language: English; (5) radiographic measurements by peri-apical x-ray; (6) implant material: titanium; and (7) no implant type selection was applied.

RESULTS

Six articles were considered eligible for full-text analysis. Unfavorable C/I ratio can be considered a potential risk factor for single crown and abutment loosening (C/I ratio ≥ 1.46) and abutment fractures in posterior areas (C/I ratio ≥ 2.01).

CONCLUSIONS

Despite the limited data, high C/I ratio may be related to some prosthetic failures. Unfavorable C/I ratio does not affect biological complications and implant failure.

Interdental Implant Papillae Grow up with Temporary Abutment displaced at Monthly Intervals

Interdental papillae regeneration remains a challenge in implant dentistry in cases in which papillae are lost following tooth extraction. This report presents an implant case with missing 1st and 2nd premolars and total papillary loss. We performed immediate provisionalization to the first premolar implant with a temporary abutment and crown, whereas the second premolar was submerged. Crown contouring and modifications to the shape and size were performed once every month (the temporary abutment and crown disconnected three times during the 3-month healing period). At the end of the 3-month healing period, papillae regeneration was observed between the implant and the adjacent tooth and between the adjacent implants. Papillae regeneration is possible with temporary abutment and a composite material crown that is properly contoured and polished, even with several abutment removals during the healing period.