O. HANISCH*, M. YILDIRIM, H. SPIEKERMANN (University of Aachen, Aachen, Germany; Loma Linda University, Loma Linda, CA, USA)
The presence or absence of the interproximal papilla is of great concern to surgeons, prosthodontists, and to patients. The loss of the papilla can lead to cosmetic deformities, phonetic problems, and food impaction. In this instance, implant-supported single tooth replacement in the anterior maxilla is a surgical and restorative challenge. The purpose of this pilot study was to compare two different treatment concepts to increase the height of lost interproximal papilla adjacent to implant-supported single tooth restorations in the anterior maxilla. A total of 6 patients requiring implant-supported single fixed restorations in the maxillary anterior area were randomly assigned to receive one of the following two treatment protocols: (1) implant surgery with simultaneous impression procedure, second-stage surgery with simultaneous insertion of the provisional restoration, final restoration; (2) implant surgery, second-stage surgery and healing abutment connection, impression procedure, provisional restoration, final restoration. A total of 14 interproximal sites adjacent to implant-supported fixed restorations were included in this study. The following measurement were taken prior to second-stage surgery and 3 months following insertion of provisional restorations: (a) distance between incisal edge of adjacent natural tooth and most coronal point of interproximal papilla; (b) distance between crest of alveolar bone and interproximal contact point. Treatment concept 1 resulted in a mean papilla height gain of 1.1 mm. Concept 2 revealed a mean gain in papilla height of 0.9 mm. These preliminary results indicate that the height of lost interproximal papilla adjacent to implant-supported single fixed restorations can be increased.