Influence of miniscrew-assisted rapid palatal expansion (MARPE) on the interdental papilla height of maxillary central incisors

OBJECTIVES

To evaluate the influence of miniscrew-assisted rapid palatal expansion (MARPE) on the interdental papilla height of maxillary central incisors.

MATERIALS AND METHODS

Patients who completed MARPE treatment at the Radboud University Medical Center between 2018 and 2021 were included in this retrospective study. The papilla height between the maxillary central incisors was evaluated on frontal intraoral photographs taken before expansion (T0) and 1.5 years after MARPE treatment (T1) using the Jemt classification. The difference in Jemt score at T0 and T1 was the primary outcome variable. In addition, gender, age, Angle classification, MARPE duration, midpalatal suture maturation stage, maximal central diastema (MCD) immediately after expansion, crown width to length ratio (W/L), pretreatment overlap of maxillary central incisors, and the distance between the approximal contact point of the central incisors and the bone crest (CP-B) were also record.

RESULTS

Twenty-two patients were included (2 men, 20 women, mean age 27.3 ± 8.8 years) and 4 patients (18%) showed a significant reduction in the Jemt score following MARPE (p = 0.04), indicating papilla recession. Interdental papilla recession was significantly associated with the increase of CP-B (p = 0.02), smaller W/L (p < 0.01), overlapping of maxillary central incisors (p < 0.01), and smaller MCD immediately after expansion (p = 0.02).

CONCLUSIONS

One and a half years after MARPE, 18% of patients exhibited mild recession of papilla height of the maxillary central incisors. Overlapping and smaller W/L of maxillary central incisors were prognostic factors for interdental papilla recession.

CLINICAL RELEVANCE

Clinicians have to be aware of and inform the patients about the occurrence of papilla recession following MARPE.

Evaluation of one-piece zirconia dental implants: An 8-year follow-up study

OBJECTIVES

Long-term studies of modern zirconia implants are still insufficient. This prospective 8-year follow-up study investigated one-piece zirconia implants.

MATERIALS AND METHODS

Patients who had received a one-piece zirconia dental implant (PURE ceramic implant, Institut Straumann GmbH, Basel, Switzerland) were included in this study. Next to the implant survival and success rates, the radiographic and clinical implant parameters were assessed.

RESULTS

The overall survival rate of 67 zirconia implants in 39 patients was 100%. The overall success rate was 89.6%. Around the immediate zirconia implants, the success rate was 94.7%, and around the delayed implants, 87.5%. The immediate implants showed a significantly higher bone crest compared to the delayed implants (p = 0.0120). According to the pink esthetic score, the immediate implants revealed more favorable esthetic results compared to the delayed implants after an 8-year follow-up (p = 0.0002).

CONCLUSIONS

After 8 years, the one-piece zirconia implants presented an 89.6% success rate. Regarding the timing of implantation, in individual cases, immediate implantation can have slight advantages over delayed implantation.

CLINICAL RELEVANCE

Immediate implants can also be considered for zirconia implants and should not be excluded on principle.

Reliability of an indirect bone-probing method for diagnosis of labial bone crest level of the mandibular anterior teeth

OBJECTIVES

To evaluate the null hypothesis that there would be no difference between the labial bone crest level of the mandibular anterior teeth evaluated with an indirect bone-probing method (IBP) and cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

Twenty-nine adult patients with a mean age of 32.15 ± 8.75 years were enrolled. An IBP based on indirect tactile perception was used to determine the labial bone crest level of the mandibular anterior teeth clinically. Bone crest perception degree, gingival thickness, and patient discomfort during IBP were also recorded. CBCT scans were used to evaluate the level and thickness of the labial bone crest. IBP and CBCT methods were compared statistically. The significance level was set at 5%.

RESULTS

There was a significant difference between the labial bone crest level diagnosed by IBP and CBCT. However, the difference was not clinically significant. IBP and CBCT measurements were significantly and strongly correlated (R = 0.74). Thinner gingival tissue was associated with a higher perception of bone crest. Only two patients reported mild to moderate discomfort during IBP.

CONCLUSIONS

IBP allowed the labial bone crest level to be determined with acceptable clinical accuracy, especially in patients with thinner gingival tissue.

Influence of surgically assisted rapid maxillary expansion on the interdental papilla height of maxillary central incisors

PURPOSE

To evaluate the influence of orthodontic treatment with surgically assisted rapid maxillary expansion (SARME) on the interdental papilla height of maxillary central incisors.

METHODS

In this retrospective study, patients who completed orthodontic treatment including SARME at the Radboud University Medical Center Orthodontic Department before December 2019 were included. Frontal intraoral photographs taken before (T1) and after completion of treatment (T2) were examined to determine the papilla height between the maxillary central incisors using the Jemt classification. The difference between the Jemt classification at T1 and T2 (∆Jemt) was defined as the primary outcome variable. Secondary outcome variables were gender, age, treatment duration, type of expansion appliance, maximal central diastema during expansion, pretreatment overlapping between the central incisors, gingival biotype, crown morphology and the distance between the bone crest and incisal contact point. Kappa statistics and paired t‑tests were used to determine reliability of the measurements. Pearson's Χ² test and independent t‑tests were used to compare the variables between the groups of patients with and without papillary recession. Finally, multiple logistic regression analysis was performed.

RESULTS

In all, 93 patients fulfilled the inclusion criteria and were included in the study. The Jemt score worsened for 30 patients (32%) between T1 and T2, indicating the occurrence of papillary recession. Incisal overlapping, crown morphology, small width to length ratio, increasing age and an increasing distance between crestal bone and the incisal contact point were factors associated with papillary recession.

CONCLUSION

After orthodontic treatment including SARME, one third of patients exhibited recession of papilla height of the maxillary central incisors.