Evaluation of the mean and maximum papilla height and factors affected the dimension of papilla around dental implants

Introduction : Esthetic is one of the essential factors especially in esthetic zone for successful implant treatment. Shape and size of dental proximal papilla is one of the substantial indices in esthetic. (1,2) Therefore identification of factors that affect the height and shape of papilla around implants are crucial. (3-5) So the aim of this study is determination of mean and maximum height of proximal papilla around implants and assessment of effective factors. Methods: In a cross-sectional study, 63 patients were selected with 92 implants. Age between 25 and 80 years, located at least one implant in the anterior region of maxilla, which lasted at least one year from its loading, the absence of obvious hyperplasia in the papilla, the lack of plastic surgery treatment in the anterior region and the lack of using systemic drugs that affect gingival enlargement considered as inclusion and exclusion criteria. Informed consent was obtained. Questionnaire including background information, materials and methods were used for assessment of occlusion reconstruction by implants. Variables affected shape and size of papilla were completed in questioners. Clinical data was collected using a periodontal probe and clinical observation by a trained examiner in three groups includes implant-tooth, implant-implant and implant-pontic. Data were analysed by Pearson correlation, Spearman, independent t-test or ANOVA and regression modelling. Results: The data of papilla around the 92 implants located in the anterior of maxilla were assessed. The mean age of participants was 52.05 ±12.28mm. The mean height of papilla in the implant-tooth region was 2.86±7.48mm, the implant-implant was 2.50±0.61mm and implant-pontic was 2.65±0.66mm. There was no significant difference in height of papilla between groups (pvalue<0.067). There was no significant relation between papilla height and the width of the keratinized gingiva (pvalue<0.834), implant location (pvalue<0.652) or gender (pvalue<0.940). The height of papilla and age had reverse relation in all three groups. (p value<0.019) Conclusion: In 184 examined areas, the maximum height of implant-tooth was 5.5 mm and the minimum was 1 mm in all three groups. Generally three groups had no significant difference. As a result it is concluded that implant can provide acceptable pink esthetic.