Choquet V, Hermans M, Adriaenssens P, Daelemans P, Tarnow D P, Malevez C
Department of Implant Dentistry, University of Brussels, Faculty of Medicine, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Clinique Universitaire de Bruxelles, Université Libre de Bruxelles, Erasme Hospital, Brussels, Belgium.
J Periodontol. 2001 Oct;72(10):1364-71. doi: 10.1902/jop.2001.72.10.1364.
The regeneration of gingival papillae after single-implant treatment is an area of current investigation. This study was designed to determine: 1) whether the distance from the base of the contact point to the crest of the bone would correlate with the presence or absence of interproximal papillae adjacent to single-tooth implants, and 2) whether the surgical technique at uncovering influences the outcome.
A clinical and radiographic retrospective evaluation of the papilla level around single dental implants and their adjacent teeth was performed in the anterior maxilla in 26 patients restored with 27 implants. Six months after insertion, 17 implants were uncovered with a standard technique, while 10 implants were uncovered with a technique designed to generate papilla-like formation around dental implants. Fifty-two papillae were available for clinical and radiographic evaluation. The presence or absence of papillae was determined, and the effects of the following variables were analyzed: the influence of the 2 surgical techniques; the vertical relation between the papilla height and the crest of bone between the implant and adjacent teeth; the vertical relation between the papilla level and the contact point between the crowns of the teeth and the implant; and the distance from the contact point to the crest of bone.
When the measurement from the contact point to the crest of bone was 5 mm or less, the papilla was present almost 100% of the time. When the distance was > or = 6 mm, the papilla was present 50% of the time or less. The mean distance between the crest of bone and the most coronal papilla level (interproximal soft tissue height) was 3.85 mm (SD = 1.04). When comparing the conventional and modified surgical technique, the relation shifted from 3.77 mm (SD = 1.01) to 4.01 mm (SD = 1.10), respectively.
These results clearly show the influence of the bone crest on the presence or absence of papillae between implants and adjacent teeth. The data also show a positive influence for the modified surgical technique, aimed at reconstructing papillae at the implant uncovering.
单颗种植治疗后牙龈乳头的再生是当前研究的一个领域。本研究旨在确定：1）从接触点基部到牙槽嵴顶的距离是否与单颗牙种植体相邻的邻间隙乳头的存在与否相关，以及2）暴露种植体时的手术技术是否会影响结果。
对26例植入27颗种植体的上颌前部单颗牙种植体及其相邻牙齿周围的乳头水平进行了临床和影像学回顾性评估。植入后6个月，17颗种植体采用标准技术暴露，而10颗种植体采用旨在在种植体周围形成乳头样结构的技术暴露。52个乳头可用于临床和影像学评估。确定乳头的存在与否，并分析以下变量的影响：两种手术技术的影响；乳头高度与种植体和相邻牙齿之间牙槽嵴顶的垂直关系；乳头水平与牙齿冠部和种植体之间接触点的垂直关系；以及从接触点到牙槽嵴顶的距离。
当从接触点到牙槽嵴顶的测量距离为5mm或更小时，乳头几乎100%存在。当距离≥6mm时，乳头出现的时间为50%或更少。牙槽嵴顶与最冠方乳头水平（邻间隙软组织高度）之间的平均距离为3.85mm（标准差=1.04）。比较传统手术技术和改良手术技术时，该关系分别从3.77mm（标准差=1.01）变为4.01mm（标准差=1.10）。
这些结果清楚地表明了牙槽嵴对种植体与相邻牙齿之间乳头存在与否的影响。数据还显示了改良手术技术的积极影响，该技术旨在在种植体暴露时重建乳头。
