title: Interproximal papillae reconstruction in maxillary implants.
abstract: BACKGROUND
  Gingival esthetics has become an important factor in the overall success of most maxillary implant-supported restorations. Periodontal plastic surgery procedures may be used to enhance esthetics in the maxillary anterior region. The purpose of the present study was to evaluate a new surgical approach, performed at implant exposure, to reconstruct interdental papillae around maxillary implant-supported restorations.
  
  
  METHODS
  The surgical procedure was performed on 32 patients, in which 36 consecutive single tooth osseointegrated implants were exposed in the anterior and premolar maxillary region. Previous to implant exposure and 6 months postoperatively, once the implant-supported restoration was in place, mesial and distal papilla contour measurements were calculated, based on a modification of the papillary index score (PIS). Statistical analysis consisted of paired t test, Pearson's correlation, and ANOVA with repeated measures.
  
  
  RESULTS
  Preoperative PIS ranged from 0 to 3 and from 1 to 3 at the 6 months follow-up control. A mean of mesial and distal papilla, within the same tooth, was used for paired t test statistical analysis. A mean increase of 1.07 (SD 0.43) in PIS was statistically significant (P<0.001). At the second measurement, in no site was PIS smaller (0%) while in 64 sites PIS was higher (89%). In 51 papilla (71%) there was an increase of 1 PIS unit and 13 (18%) of 2 PIS units between both measurements.
  
  
  CONCLUSIONS
  The presented surgical technique performed at second stage implant surgery was useful for partial or total interproximal papilla reconstruction adjacent to maxillary single-implant restorations.
authors.affiliation: Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel. carlos@post.tau.ac.il
authors.forename: C E
authors.initials: CE
authors.lastname: Nemcovsky
authors.forename: O
authors.initials: O
authors.lastname: Moses
authors.forename: Z
authors.initials: Z
authors.lastname: Artzi
mesh_terms: D000704:Analysis of Variance; D002985:Clinical Protocols; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D005893:Gingivoplasty / Q000379:methods*; D007180:Incisor; D008437:Maxilla; D018709:Statistics, Nonparametric