Evidence-based knowledge on the aesthetics and maintenance of peri-implant soft tissues: Osteology Foundation Consensus Report Part 3-Aesthetics of peri-implant soft tissues.

Abstract

Working Group 2 at the 2nd Consensus Meeting of the Osteology Foundation had a focus on the influence of vertical implant placement on papilla height at single implants adjacent to teeth and on the inter-implant mucosa fill at two adjacent implants in the anterior maxilla. Two systematic reviews were prepared in advance of the consensus meeting. Due to the heterogeneity among the studies with regard to study design, study population, method of assessment, meta-analyses were not possible. Consensus statements, clinical recommendations, and implications for future research were based on structured group discussions until consensus was reached among the entire expert group. The systematic review about single-tooth implants included a total of 12 studies demonstrating that the vertical distance from the crestal bone level to the base of the interproximal contact point varied considerably from 2mm up to 11mm, and a partial or complete papilla fill was reached in 56.5% to 100% of the cases. For the systematic review regarding two adjacent implants, only four studies reported on horizontal inter-implant distances which ranged between 2.0 and 4.0mm. More than half of the papilla presence was indicated in 21% to 88.5% of the cases. It was concluded that for single-tooth implants, the papilla height between an implant and a tooth is predominantly dependent on the clinical attachment level of the tooth. In cases with two adjacent implants, it was concluded that it is not possible to define the optimal horizontal distance between two adjacent implants restored with fixed dental prosthess.