Abstract

BackgroundPreservation of the interdental papilla is an essential part of the functional and esthetic rehabilitation of dental treatment. It has been described that thicker gingival tissues are more resistant to recession. The main objective of this investigation was to analyze whether a thin gingival phenotype represents a potential risk indicator affecting interdental papilla fill, height, or width in an esthetic region between maxillary central incisors. The secondary goals were: (1) to analyze parameters describing the papilla—fill, height, width, and effect of papilla base width on the vertical papillary dimension; (2) to determine correlation between different non-invasive measurements of gingival thickness; (3) to compare both sexes.MethodsA total of 54 periodontally healthy students (20–30 years old) were included in the study. Gingival thickness was measured using Pirop Ultrasonic Biometer. Gingival phenotype was also assessed by gingival probe transparency. Papilla height and width were measured, and the degree of papilla recession was classified.ResultsNo significant relationship between papilla fill, height, width and gingival probe transparency or gingival thickness was found. Gingival thickness and gingival probe transparency showed a significant relationship (P < 0.001). There was a significant relationship between papilla height and papilla fill (P = 0.028). A papilla which filled the interdental space completely seemed to be shorter. A strong positive correlation between papilla height and papilla width was found (P < 0.0001). The papilla between maxillary central incisors was significantly higher in males (P = 0.01).ConclusionThe appearance of the interdental papilla may be influenced by various factors. Within the limitations of this study, the results showed that the thin gingival phenotype alone is no potential risk indicator affecting interdental papilla fill, height, or width. It seems that there may be some effect of papilla base width on its vertical dimension. Gingival probe transparency is a simple reliable method of assessment of gingival thickness with a threshold value of 1-mm gingival thickness between the thick and thin phenotypes.

Highlights

  • Preservation of the interdental papilla is an essential part of the functional and esthetic rehabilitation of dental treatment

  • Intraclass correlation coefficient (ICC) for the gingival thickness parameter (0.933) showed an excellent match, but the Dahlberg error rate of variation was higher than 5%

  • To have a homogeneous sample, we only studied the papilla between maxillary central incisors, because contact points may vary in different regions, which may influence the shape of the interdental papilla

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Summary

Introduction

Preservation of the interdental papilla is an essential part of the functional and esthetic rehabilitation of dental treatment. In some situations, specific problems with the so-called pink esthetic occur, comprising the mucogingival conditions, such as excessive gingival display, uneven gingival contours, exposure of root surfaces, or loss of the interdental papilla. In such cases, it is essential to analyze the patient’s smile line [2]. If a papilla does not fill the whole interdental space, a black triangle occurs It is considered an esthetic impairment, and it can cause phonetic problems or food retention, which can adversely affect periodontal health [3]. Clinicians should be able to adequately analyze the factors related to the interproximal papilla to prevent its loss

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