Division of Maxillofacial Surgery, University of Torino, Torino, Italy.
Private Practice, Torino, Italy.
Clin Oral Implants Res. 2018 Mar;29 Suppl 15:50-61. doi: 10.1111/clr.13116.
The aim of this systematic review was to investigate the tooth-implant papilla formation in correlation with the distance between the interproximal bone level and the prosthetic contact point.
A comprehensive search of the current literature (01/01/2000-01/01/2017) was performed to identify human trials that included 10 patients or more, with at least 12 months follow-up, in need of the replacement of one single tooth in the anterior maxillary region with an implant-supported single crown. To meet the inclusion criteria, studies had to provide both radiographic and clinical data regarding the distance between the interproximal bone level and the prosthetic contact point.
The search yielded 136 records. After evaluation of abstracts and full texts, 12 papers were included in the final review, even though various reference points, for the comparison between the vertical distance and the papilla height, were used. The vertical distance between the interproximal bone level and prosthetic contact point ranged between 2 and 11 mm, and the partial or complete papilla fill (Jemt's score 2-3) ranged between 56.5% and 100% of cases.
There is limited evidence that the vertical distance from the base of the interproximal contact point to the crestal bone level seems to affect the interproximal papilla height; that is, the lower is the distance the higher is the percentage of papilla fill. Complete embrasure fill between an implant restoration and the adjacent tooth seems to be correlated with the integrity of the periodontal ligament of the tooth. To reduce the risk of aesthetic failures, interproximal probing on the adjacent teeth should be encouraged before implant placement.
本系统评价的目的是研究牙种植体乳头形成与近中骨水平和修复体接触点之间的距离的相关性。
对当前文献（2000 年 1 月 1 日至 2017 年 1 月 1 日）进行了全面检索，以确定包含 10 名或更多名患者的人类试验，这些患者在前上颌区域需要用种植体支持的单冠替换单个牙齿，至少有 12 个月的随访。为了符合纳入标准，研究必须提供关于近中骨水平和修复体接触点之间距离的放射学和临床数据。
搜索结果为 136 条记录。在评估了摘要和全文后，有 12 篇论文被纳入最终综述，尽管为了比较垂直距离和乳头高度，使用了各种参考点。近中骨水平和修复体接触点之间的垂直距离为 2 至 11mm，部分或完全的乳头填充（Jemt 评分 2-3）为 56.5%至 100%的病例。
有有限的证据表明，从近中接触点的基底到牙槽骨顶的垂直距离似乎会影响近中乳头的高度，即距离越低，乳头填充的百分比越高。种植体修复体和相邻牙齿之间完全的邻间隙填充似乎与牙齿牙周韧带的完整性有关。为了降低美学失败的风险，在植入物放置之前，应鼓励对相邻牙齿进行近中探查。
