title: Evaluation of Hard and Soft Tissue Dimensions Around Zirconium Oxide Implant-Supported Crowns: A 1-Year Retrospective Study.
abstract: This study aims to evaluate the effect of the distance between the alveolar crest of a full-ceramic implant to the lowest point of the contact area of the crowns on the interdental papilla. Therefore, the authors proposed a new concept of linear measurements for the reproducible and metric evaluation of distances relevant for the assessment of hard and soft tissue changes around dental implants.
  
  
  
  A total of 216 sites were examined in 87 patients. In a radiographic and clinical evaluation, four relevant distances were evaluated. In the x-ray image, the tip of the papilla was marked with a radiodense mixture of tungsten powder and temporary cement. In a clinical photograph, the lowest point of the interdental contact zone of the crowns was visualized by a metallic interdental ligature.
  
  
  
  Using the proposed measuring methodology, four different papilla-deficit situations around ceramic implants could be reproducibly distinguished. When the measurement from the bone crest at the implant was ≤5 mm, the papilla was completely present in 100% of cases. When this distance was 10 mm, the papilla was still present in 67% of the cases, without any cosmetically apparent deficit.
  
  
  
  A close relationship is observed between the distance from the contact point to the bone and the presence of the papilla. Using a combination of radiographically and clinically visible landmarks allows the reproducible measurement of these distances.
authors.affiliation: Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Aachen, Aachen, Germany.
authors.forename: Kristian
authors.initials: K
authors.lastname: Kniha
authors.affiliation: Private practice, Munich, Germany.|Department of Oral and Cranio-Maxillofacial Surgery, Hightech Research Center, University Hospital Basel, University of Basel, Basel, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Gahlert
authors.affiliation: Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hicklin
authors.affiliation: Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.
authors.forename: Urs
authors.initials: U
authors.lastname: Brägger
authors.affiliation: Private practice, Munich, Germany.
authors.forename: Heinz
authors.initials: H
authors.lastname: Kniha
authors.affiliation: Department of Anatomy Munich, Ludwig-Maximilians University Munich, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Milz
mesh_terms: D003442:Crowns; D003758:Dental Implantation, Endosseous; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D004955:Esthetics, Dental; D005881:Gingiva; D006801:Humans; D012189:Retrospective Studies; D015040:Zirconium
chemical_list: D015040:Zirconium; C028541:zirconium oxide
keywords: Crown; dental implants; esthetics; gingiva; radiography; zirconium