Gastaldo Jose Fabio, Cury Patricia Ramos, Sendyk Wilson Roberto
Department of Periodontics and Implantology, School of Dentistry, University of Santo Amaro, Santo Amaro, Brazil.
J Periodontol. 2004 Sep;75(9):1242-6. doi: 10.1902/jop.2004.75.9.1242.
The interproximal dental papilla is considered an essential component of the anterior and posterior regions of the maxilla and mandible. The absence of this structure has esthetic and phonetical consequences and lateral food impaction problems occur with the implant-supported prosthesis. The aims of the present study were to: 1) evaluate the effect of the vertical and horizontal distances between adjacent implants (group 1) and between a tooth and an implant (group 2) on the presence of the interproximal dental papilla; and 2) determine whether the interaction between the vertical and horizontal distances might be associated with the incidence of the papilla.
In 48 patients, 96 interproximal sites in group 1 and 80 in group 2 were examined. The distance from the base of the contact point to the bone crest (D1), the distance between tooth and implant or between two implants (D2), and the distance from the base of the contact point to the tip of the papilla (D3) were measured.
In both groups, when D2 was 3, 3.5, or 4 mm, the papilla was present most of the time (P < 0.05), and when D2 was 2 or 2.5 mm, the papilla was absent 100% of the time (P < 0.05). Further, in group 2, when D1 was between 3 and 5 mm, the papilla was present most of the time (P < 0.05). However, in Group 1, only when D1 was 3.0 mm was the papilla present most of the time (P < 0.05). For both groups, analysis of the interaction between D1 and D2 showed that when D2 was < or = 2.5 mm, the papilla was absent; otherwise, when D2 was > or = 3 mm, there was an interaction between D1 and D2.
We conclude that the ideal distance from the base of the contact point to the bone crest between adjacent implants is 3 mm and, between a tooth and an implant, 3 mm to 5 mm. The ideal lateral spacing between implants and between tooth and implant is 3 mm to 4 mm. Further, there is an interaction between horizontal and vertical distances when the lateral spacing is greater than 3 mm.
牙间乳头被认为是上颌骨和下颌骨前后区域的重要组成部分。该结构的缺失会产生美学和语音方面的影响，并且种植体支持的修复体会出现侧向食物嵌塞问题。本研究的目的是：1）评估相邻种植体之间（第1组）以及牙齿与种植体之间（第2组）的垂直和水平距离对牙间乳头存在情况的影响；2）确定垂直和水平距离之间的相互作用是否可能与牙乳头的发生率相关。
对48例患者进行检查，第1组有96个牙间部位，第2组有80个牙间部位。测量从接触点底部到牙槽嵴的距离（D1）、牙齿与种植体之间或两个种植体之间的距离（D2）以及从接触点底部到牙乳头尖端的距离（D3）。
在两组中，当D2为3、3.5或4mm时，牙乳头大部分时间存在（P<0.05），而当D2为2或2.5mm时，牙乳头100%不存在（P<0.05）。此外，在第2组中，当D1在3至5mm之间时，牙乳头大部分时间存在（P<0.05）。然而，在第1组中，仅当D1为3.0mm时，牙乳头大部分时间存在（P<0.05）。对于两组，D1和D2之间相互作用的分析表明，当D2≤2.5mm时，牙乳头不存在；否则，当D2≥3mm时，D1和D2之间存在相互作用。
我们得出结论，相邻种植体之间从接触点底部到牙槽嵴的理想距离为3mm，牙齿与种植体之间为3至5mm。种植体之间以及牙齿与种植体之间的理想侧向间距为3至4mm。此外，当侧向间距大于3mm时，水平和垂直距离之间存在相互作用。
