Incision Design and Soft Tissue Management to Establish an Interproximal Papilla Around Integrated Implants: A Case Series

One of the challenges in creating an esthetic and successful dental implant restoration is the maintenance or reconstruction of the interproximal papilla. Many surgical and prosthetic techniques have been attempted to maintain or regenerate the missing interproximal papilla adjacent to dental implants. According to the literature, the results to date have been unpredictable (8-10). The papilla height between an implant and natural tooth was reported to average 4.5 mm, with a maximum of 5 mm after one year of final prosthesis insertion (11). The average height of interproximal tissue between 2 adjacent implants from the crestal bone peak to the height of the papilla has been reported to be approximately 3.5mm (12). However, improper management of soft tissues often results in loss of papilla between teeth and implants, which is difficult to correct (5).