Surgical and prosthetic management of interproximal region with single-implant restorations: 1-year prospective study.
BACKGROUND
Gingival esthetics around dental implants have become a main focus for clinicians. This study analyzed the surgical, prosthetic, and anatomic factors involved in the management of peri-implant tissues.


METHODS
Forty-eight subjects with one tooth scheduled for tooth extraction and immediate implant placement were included in the study. After healing, the implants were restored with single-crown fixed prostheses. The following parameters were assessed after 12 months: presence/absence of the interproximal papilla, interimplant-tooth distance (ITD), distance from the base of the contact point to the interdental bone (CPB), and soft tissue biotype. ITD and CPB values were derived from computer analysis of periapical radiographs. A statistical analysis determined the effect of ITD and CPB on the presence of the interproximal papilla.


RESULTS
Papilla was significantly present (P <0.05) for ITD of 2.5 to 4 mm in anterior and posterior areas and for CPB < or =7 mm in posterior areas. Thick biotype was significantly associated (P <0.05) with the presence of the papilla.


CONCLUSIONS
The combination of surgical and prosthetic plans represents the key factor to optimize predictability in single-implant esthetics. The recommended interproximal distance between the implant and the adjacent tooth is 2.5 to 4 mm. The distance from the contact point to the interdental bone is recommended to be <7 mm. Papilla presence is also correlated with a thick gingival biotype.
Romeo
Eugenio
E
Department of Prosthodontics, Dental Clinic, School of Dentistry, University of Milan, Via Beldiletto 1/3, Milan, Italy. eugenio.romeo@unimi.it
Lops
Diego
D
Rossi
Alessandro
A
Storelli
Stefano
S
Rozza
Roberto
R
Chiapasco
Matteo
M
D000293:Adolescent; D000328:Adult; D000539:Alveolar Process / Q000000981:diagnostic imaging; D003442:Crowns; D003758:Dental Implantation, Endosseous; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D004955:Esthetics, Dental; D005260:Female; D005881:Gingiva / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009811:Odontometry; D011446:Prospective Studies; D019252:Radiography, Dental, Digital