Interimplant papilla reconstruction: assessment of soft tissue changes and results of 12 consecutive cases.

BACKGROUND: Loss of soft tissue between adjacent implants is a frequent occurrence. Reconstruction of the papilla between adjacent implants is often necessary where there are esthetic demands. The purpose of this article is to describe a fixed and reproducible reference line which can be used to measure changes in the height of the interimplant papillae. A surgical technique carried out at the time of the abutment connection surgery is also described to show the changes that may occur over a 12-month period. Assessment of changes in the soft tissue dimension is shown following a modified flap technique at the time of abutment connection.

METHODS: With the aid of clinical photographs taken preoperatively, a reference line can be drawn between the highest point of the gingival margins on teeth distal to the intended site of soft tissue surgery. This reference line can be reproduced on clinical photographs postoperatively. Using this reference line, the changes in soft tissue height using a modified flap technique in 12 consecutive patients are presented. Assessment of the vertical height of the interimplant papillae before and after treatment is described.

RESULTS: Four patients showed an increase in the height of the papillae when reviewed 12 months following abutment connection. One patient showed no change in the height of the papillae, and 7 patients showed a loss in papillary height. There was an average loss of 0.5 mm in height of the interimplant soft tissue.

CONCLUSIONS: Use of a fixed reference line to assess the outcome of treatment is necessary when evaluating vertical changes in soft tissue. This reference line is used to assess a soft tissue flap technique carried out at the time of implant exposure.