Papillae alterations around single-implant restorations in the anterior maxillae: thick versus thin mucosa

To evaluate the papilla alterations around single-implant restorations in the anterior maxillae after crown attachment and to study the influence of soft tissue thickness on the papilla fill alteration. According to the inclusion criteria, 32 patients subjected to implant-supported single-tooth restorations in anterior maxillae were included. The patients were assigned to two groups according to the mucosal thickness: (i) group 1, 1.5 mm≤mucosal thickness≤3 mm; and (ii) group 2, 3 mm<mucosal thickness≤4.5 mm. Assessments of interproximal papillae at the time of crown placement (baseline) and at 6-month postloading (follow-up) were made by two prosthodontists using papilla fill index (PFI). The mean mucosal thickness was (2.49±0.31) mm (group 1) and (3.81±0.31) mm (group 2) for the two groups respectively. A significant difference in PFI between the groups was detected at the baseline (P<0.001). PFI improvements over time occurred after 6-month follow-up irrespective of the groups. When compared to group 1, the likelihood to obtain papilla fill was significantly higher for group 2 with an odds ratio of 6.05 (P<0.001). The interproximal papilla level around single-implant restorations could improve significantly over time after 6-month restoration according to PFI assessment. The thicker mucosa before implant placement implied a more favorable esthetic outcome in papilla alteration. After insertion of a crown, individuals with naturally thick gum tissue may have a higher chance of it regenerating properly, research from China shows. In a pilot study of 40 individuals, Hong-Chang Lai at the Shanghai Jiao Tong University School of Medicine and colleagues at this university and the University of Hong Kong, tracked the natural response of gum tissue (mucosa) for six months following a single front tooth crown insertion with no post-crown intervention. The researchers focused on the development of the papillae—the triangular sections of gum between teeth—around the crown. Their results showed that the participants with a naturally thicker mucosa tended to develop a neater, more aesthetically acceptable papilla around the crown, avoiding the so-called ‘black triangle’ effect of missing or discolored papilla.