title: Disparity in embrasure fill and papilla height between tooth- and implant-borne fixed restorations in the anterior maxilla: a cross-sectional study.
abstract: OBJECTIVE
  The objective of the present study was to compare inter-proximal fill and papilla height between different embrasures.
  
  
  METHODS
  One hundred and fifty non-smoking consecutive patients (mean age 54, range 32-73; 63 males and 87 females) without periodontal disease were selected in a multidisciplinary practice during regular supportive care. All had been treated for multiple tooth loss in the anterior maxilla at least 1 year earlier by means of a fixed restoration on teeth (n = 50) or implants (n = 100) using straightforward procedures (without hard and/or soft tissue augmentation). Embrasure fill was assessed by means of Jemt's papilla index and papilla height was registered following local anaesthesia by means of bone sounding by one clinician.
  
  
  RESULTS
  Tooth-pontic and tooth-implant embrasures demonstrated comparable inter-proximal fill and papilla height (≥58% Jemt's score 3; mean papilla height ≥4.1 mm). Between missing teeth, embrasure fill and papilla height were lower regardless of the embrasure type. The implant-implant and implant-pontic embrasure demonstrated comparable outcome (≤42% Jemt's score 3; mean papilla height ≤ 3.3 mm; p ≥ 0.416), which was significantly poorer when compared to the pontic-pontic embrasure (82% Jemt's score 3; mean papilla height 3.7 mm; p ≤ 0.019). Overall, papilla index and papilla height demonstrated a weak correlation (Spearman's correlation coefficient: 0.198; p = 0.002).
  
  
  CONCLUSIONS
  The re-establishment of a papilla is difficult when there is no tooth involved. In that scenario a short papilla should be expected and implant-borne restorations demonstrate the poorest outcome. Moreover, an implant with a pontic may not perform better than adjacent implants.
authors.affiliation: Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, University of Ghent, De Pintelaan 185, B-9000 Ghent, Belgium. jan.cosyn@ugent.be
authors.forename: Jan
authors.initials: J
authors.lastname: Cosyn
authors.forename: Magalie
authors.initials: M
authors.lastname: Raes
authors.forename: Mathieu
authors.initials: M
authors.lastname: Packet
authors.forename: Roberto
authors.initials: R
authors.lastname: Cleymaet
authors.forename: Hugo
authors.initials: H
authors.lastname: De Bruyn
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D000044:Dental Abutments; D019250:Dental Implants, Single-Tooth; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D003779:Denture Design; D003830:Denture, Partial, Fixed; D005260:Female; D005881:Gingiva / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D016388:Tooth Loss / Q000534:rehabilitation