Influence of interdental embrasures on interdental papilla
-
Sameer Kedia
,
Kanteshwari Kumathalli
,
Raja Sridhar
,
Simran Parwani
,
Satyajit Tekade
,
Ashish Warekar
Abstract
Background: There is growing attention on anterior esthetics by both dentists and patients, which emphasizes the need for conduct of study encompassing the anatomical features of an embrasure and correlating with papilla fill. Hence the present study has been designed to meet these parameters, including food lodgement. Aim: To assess the influence of anatomical and morphological characteristics of interdental embrasures on interdental papilla and food lodgement.Objectives: Were set as the following: 1. Correlation of modified papilla index score (PIS) with interdental anatomical measurements as follows: a. Distance between Contact Point and Bone Crest (CP-BC). b. Interdental Distance (IDD). c. Embrasure Space Area (EA). d. Crown Form (CF). e. Papilla Length (PL). 2. To determine the optimal dimensions of interdental embrasure between maxillary incisors so as to be completely filled by normal healthy interdental papilla. 3. To correlate occurrence of food lodgement with Modified Papilla Index Score (PIS) and Embrasure Space Area (EA).Materials and Methods: 532 patients aged 18-58 years who had fully erupted permanent dentition and healthy gingiva with probing depth≤3mm were included into the study. Quantitative analysis of interdental papillae were done using clinical parameters along with radiographic examination. Results: The clinical and radiographic assessment of 1312 interdental papillae revealed that the interdental anatomical factors viz (which are) CP-BC distance, IDD, EA, CF and PL significantly influenced the degree of papilla fill. The study also highlighted the possible occurrence of food lodgment in patients with open embrasures. Conclusion: Embrasure anatomical parameters and papillary heightvary widely among individuals. Interdental papillary deficiency is a relative phenomenon since it is an outcome of net influence of all the other parameters. Keywords: Embrasures; Interdental papilla; Food lodgment; Papillary height; Crown form; Esthetics.
1. Cho HS, Jang SH, Kim DK et al. The effect of interproximal distance between roots on the existence of interdental papillae according to the distance from the contact point to the alveolar crest. J Periodontol2006;77:1651-1657.
2. Choquet V, Hermans M, Adriaenssens P, DaelemansP,Tarnow DP, Malevz C. Clinical and radiographic evaluation of the papilla level adjacent to single-tooth dental implants: A retrospective study in the maxillary anterior region. J Periodontol2001;72:1364-1371.
3. Chang LC. The presence of a central papilla is associated with age but not gender. J Dent Sci 2006;1:161:167.
4. Chang LC. Age-Related Central Papilla Recession in Different Embrasure Morphologies. Chin J Periodontol2007;12:71-82.
5. Martegani P, Silvestri M, Mascarello F et al. Morphometric study of the interproximal unit in the esthetic region to correlate anatomic variables affecting the aspect of soft tissue embrasure space. J Periodontol2007;78:2260-2265.
6. Wu YJ, Tu YK, Huang SM and Chan CP. The influence of the distance from the contact point to the crest of bone on the presence of interproximal dental papilla. Chang Gung Med J 2003;26:822-8.
7. Lee DW, Kim CK, Park KH, Cho KS and Moon IS. Non-invasive method to measure the length of soft tissue from the top of the papilla to the crestal bone. J Periodontol2005;76:1311-1314.
8. Prato GP, Rotundo R, Cortellini P, Tinti C, Azzi R. Interdental papilla management: A review and classification of the therapeutic approaches. Int J Periodontics Restorative Dent 2004;24:246-255.
9. Chang LC. The central papilla height in association with age and gender – assessed with a new method. Chin J Periodontol2006;11:271:279.
10. Chang LC. Assessment of parameters affecting the presence of the central papilla using a non-invasive radiographic method. J Periodontol2008;79:603-609.
11. Zetu L, Wang HL. Management of inter-dental/inter-implant papilla. J Clin Periodontol2005;32:831-839.
12. Chang LC. Criteria for predicting the presence of the central papilla by a noninvasive method. J Dent Sci 2007;2:88-96.
13. Tarnow DP, Magner AW, Fletcher P. The Effect of the Distance From the Contact Point to the Crest of Bone on the Presence or Absence of the Interproximal Dental Papilla. J Periodontol1992;63:995–996.
14. Cardaropoli D, Stefania MD and Corrente G. The Papilla Presence Index (PPI): A new system to assess interproximal papillary levels. Int J Periodontics Restorative Dent 2004;14:488-492.
15. Chang LC. The association between embrasure morphology and central papilla recession. J Clin Periodontol2007;34:432-436.
16. Kurth JR and Kokich VG. Open gingival embrasures after orthodontic treatment in adults: Prevalence and etiology. Am J Orthod Dentofacial Orthop2001;120:116-23.
17. Gastaldo JF, Cury PR and Sendyk WR. Effect of the vertical and horizontal distance between adjacent implants and between a tooth and an implant on the incidence of interproximal papilla. J Periodontol2004;75:1242-1246.
18. Chen MC, Liao YF, Chan CP et al. Factors influencing the presence of interproximal dental papillae between maxillary anterior teeth. J Periodontol2010;81:318-324.
19. Cohen B. Morphological factors in the pathogenesis of periodontal disease. Brit Den J 1959;107:31-39.
20. Kohl JT, Zander HA. Morphology of interdental gingival tissues. Oral Surg Oral Med Oral Pathol1961;60:287-295.
21. Matherson DG, Zander HA. Evaluation of osseous surgery in monkeys. J Dent Res 1963;42(Spec. Issue)116.
22. Stahl SS. Morphology and healing pattern of human. NY State Dent J 1963;29:307-311.
23. Lee DW, Park KH and Moon IS. Dimension of kertatinized mucosa and the interproximal papilla between adjacent implants. J Periodontol2005;76:1856-1860.
24. Ryser MR, Block MS and Mercante DE. Correlation of papilla to crestal bone levels around single tooth implants in immediate or delayed crown protocols. J Oral Maxillofac Surg 2005;63:1184-1195.
25. Chow YC, Eber RM, Tsao YP et al. Factors associated with the appearance of gingival papillae. J Clin Periodontol2010;37:719-727.
26. Montevecchi1 M, Checchi V, Piana L et al. Variables Affecting the Gingival Embrasure Space in Aesthetically Important Regions: Differences between Central and Lateral Papillae. The Open Dentistry Journal 2011;5:126-135.
27. Nozawa T, Yamaguchi S, Ookame Yet al. The distances between the facial and palatal papillae in the maxillary anterior dentition. Eur J Esthet Dent 2011;6:88-93.
28. Nordland WP and Tarnow DP. A classification system for loss of papillary height. J Periodontol1998;69:1124-1126.
29. Jemt T. Regeneration of gingival papillae after single-implant treatment. Int J Periodont Rest Den 1997;17:327-333.
30. Nemcovsky CE, Moses O and Artzi Z. Interproximal papillae reconstruction in maxillary implants. J Periodontol2000;71:308-314.
31. Nemcovsky CE. Interproximal Papilla Augmentation Procedure: A Novel Surgical Approach and Clinical Evaluation of 10 Consecutive Procedures. Int J Periodontics Restorative Dent 2001;21:553–559.
32. Kanteshwari IK. A Modified Horizontal Gingival Incision: An approach to Endo-Perio lesions - Two case reports. JPFA 2011;25:35-44.
33. Salama H, Salama MA, Garber D, Adar P.The interproximal height of bone: a guidepost to predictable aesthetic strategies and soft tissue contours in anterior tooth replacement. Pract Periodontics Aesthet Dent 1998;10(9):1131-41.
34. Heins PJ and Wieder SM. A Histologic Study of the Width and Nature of Inter-radicular Spaces in Human Adult Pre-molars and Molars. Journal of Dental Research 1986;65:6948-951.
35. LaSota EP. Orthodontic considerations in prosthetic and restorative dentistry. Dental Clinics of North America 1988;32(3):447-456.
36. Kokich VG. Esthetics: The Orthodontic – Periodontic Restorative connection. Seminars in Orthodontics 1966;2(1):21-30.
37. Kois JC. Predictable single tooth peri-implant esthetics: five diagnostic keys. Comp of Cont Edu in Dent 2001;22(3):199-206.
38. Kois JC, Kan JY. Predictable peri-implant gingival aesthetics: surgical and prosthodontic rationales. PractProcedAesthet Dent. 2001;13(9):691-8.
39. Kois JC. Predictable single tooth peri-implant esthetics: five diagnostic keys. Comp of Cont Edu in Dent 2004;25(11):895-906.
40. Atherton JD. The gingival response to orthodontic tooth movement. American Journal of Orthodontics 1970;58:179-186.
41. Clark DJ.Restoratively Driven Papilla Regeneration: Correcting the Dreaded “Black Triangle”. Canadian Journal of Restorative Dentistry and Prosthondontics2008;Aug:21-27.
42. Tarnow D, Elian N, Fletcher P, Froum S, Magner A, Cho SC, Salama M, Salama H and Garber DA. Vertical Distance from the Crest of the Bone to the Height of the Interproximal Papill Between Adjacent Implants. J Periodontol 2003;74:1785:17
2. Choquet V, Hermans M, Adriaenssens P, DaelemansP,Tarnow DP, Malevz C. Clinical and radiographic evaluation of the papilla level adjacent to single-tooth dental implants: A retrospective study in the maxillary anterior region. J Periodontol2001;72:1364-1371.
3. Chang LC. The presence of a central papilla is associated with age but not gender. J Dent Sci 2006;1:161:167.
4. Chang LC. Age-Related Central Papilla Recession in Different Embrasure Morphologies. Chin J Periodontol2007;12:71-82.
5. Martegani P, Silvestri M, Mascarello F et al. Morphometric study of the interproximal unit in the esthetic region to correlate anatomic variables affecting the aspect of soft tissue embrasure space. J Periodontol2007;78:2260-2265.
6. Wu YJ, Tu YK, Huang SM and Chan CP. The influence of the distance from the contact point to the crest of bone on the presence of interproximal dental papilla. Chang Gung Med J 2003;26:822-8.
7. Lee DW, Kim CK, Park KH, Cho KS and Moon IS. Non-invasive method to measure the length of soft tissue from the top of the papilla to the crestal bone. J Periodontol2005;76:1311-1314.
8. Prato GP, Rotundo R, Cortellini P, Tinti C, Azzi R. Interdental papilla management: A review and classification of the therapeutic approaches. Int J Periodontics Restorative Dent 2004;24:246-255.
9. Chang LC. The central papilla height in association with age and gender – assessed with a new method. Chin J Periodontol2006;11:271:279.
10. Chang LC. Assessment of parameters affecting the presence of the central papilla using a non-invasive radiographic method. J Periodontol2008;79:603-609.
11. Zetu L, Wang HL. Management of inter-dental/inter-implant papilla. J Clin Periodontol2005;32:831-839.
12. Chang LC. Criteria for predicting the presence of the central papilla by a noninvasive method. J Dent Sci 2007;2:88-96.
13. Tarnow DP, Magner AW, Fletcher P. The Effect of the Distance From the Contact Point to the Crest of Bone on the Presence or Absence of the Interproximal Dental Papilla. J Periodontol1992;63:995–996.
14. Cardaropoli D, Stefania MD and Corrente G. The Papilla Presence Index (PPI): A new system to assess interproximal papillary levels. Int J Periodontics Restorative Dent 2004;14:488-492.
15. Chang LC. The association between embrasure morphology and central papilla recession. J Clin Periodontol2007;34:432-436.
16. Kurth JR and Kokich VG. Open gingival embrasures after orthodontic treatment in adults: Prevalence and etiology. Am J Orthod Dentofacial Orthop2001;120:116-23.
17. Gastaldo JF, Cury PR and Sendyk WR. Effect of the vertical and horizontal distance between adjacent implants and between a tooth and an implant on the incidence of interproximal papilla. J Periodontol2004;75:1242-1246.
18. Chen MC, Liao YF, Chan CP et al. Factors influencing the presence of interproximal dental papillae between maxillary anterior teeth. J Periodontol2010;81:318-324.
19. Cohen B. Morphological factors in the pathogenesis of periodontal disease. Brit Den J 1959;107:31-39.
20. Kohl JT, Zander HA. Morphology of interdental gingival tissues. Oral Surg Oral Med Oral Pathol1961;60:287-295.
21. Matherson DG, Zander HA. Evaluation of osseous surgery in monkeys. J Dent Res 1963;42(Spec. Issue)116.
22. Stahl SS. Morphology and healing pattern of human. NY State Dent J 1963;29:307-311.
23. Lee DW, Park KH and Moon IS. Dimension of kertatinized mucosa and the interproximal papilla between adjacent implants. J Periodontol2005;76:1856-1860.
24. Ryser MR, Block MS and Mercante DE. Correlation of papilla to crestal bone levels around single tooth implants in immediate or delayed crown protocols. J Oral Maxillofac Surg 2005;63:1184-1195.
25. Chow YC, Eber RM, Tsao YP et al. Factors associated with the appearance of gingival papillae. J Clin Periodontol2010;37:719-727.
26. Montevecchi1 M, Checchi V, Piana L et al. Variables Affecting the Gingival Embrasure Space in Aesthetically Important Regions: Differences between Central and Lateral Papillae. The Open Dentistry Journal 2011;5:126-135.
27. Nozawa T, Yamaguchi S, Ookame Yet al. The distances between the facial and palatal papillae in the maxillary anterior dentition. Eur J Esthet Dent 2011;6:88-93.
28. Nordland WP and Tarnow DP. A classification system for loss of papillary height. J Periodontol1998;69:1124-1126.
29. Jemt T. Regeneration of gingival papillae after single-implant treatment. Int J Periodont Rest Den 1997;17:327-333.
30. Nemcovsky CE, Moses O and Artzi Z. Interproximal papillae reconstruction in maxillary implants. J Periodontol2000;71:308-314.
31. Nemcovsky CE. Interproximal Papilla Augmentation Procedure: A Novel Surgical Approach and Clinical Evaluation of 10 Consecutive Procedures. Int J Periodontics Restorative Dent 2001;21:553–559.
32. Kanteshwari IK. A Modified Horizontal Gingival Incision: An approach to Endo-Perio lesions - Two case reports. JPFA 2011;25:35-44.
33. Salama H, Salama MA, Garber D, Adar P.The interproximal height of bone: a guidepost to predictable aesthetic strategies and soft tissue contours in anterior tooth replacement. Pract Periodontics Aesthet Dent 1998;10(9):1131-41.
34. Heins PJ and Wieder SM. A Histologic Study of the Width and Nature of Inter-radicular Spaces in Human Adult Pre-molars and Molars. Journal of Dental Research 1986;65:6948-951.
35. LaSota EP. Orthodontic considerations in prosthetic and restorative dentistry. Dental Clinics of North America 1988;32(3):447-456.
36. Kokich VG. Esthetics: The Orthodontic – Periodontic Restorative connection. Seminars in Orthodontics 1966;2(1):21-30.
37. Kois JC. Predictable single tooth peri-implant esthetics: five diagnostic keys. Comp of Cont Edu in Dent 2001;22(3):199-206.
38. Kois JC, Kan JY. Predictable peri-implant gingival aesthetics: surgical and prosthodontic rationales. PractProcedAesthet Dent. 2001;13(9):691-8.
39. Kois JC. Predictable single tooth peri-implant esthetics: five diagnostic keys. Comp of Cont Edu in Dent 2004;25(11):895-906.
40. Atherton JD. The gingival response to orthodontic tooth movement. American Journal of Orthodontics 1970;58:179-186.
41. Clark DJ.Restoratively Driven Papilla Regeneration: Correcting the Dreaded “Black Triangle”. Canadian Journal of Restorative Dentistry and Prosthondontics2008;Aug:21-27.
42. Tarnow D, Elian N, Fletcher P, Froum S, Magner A, Cho SC, Salama M, Salama H and Garber DA. Vertical Distance from the Crest of the Bone to the Height of the Interproximal Papill Between Adjacent Implants. J Periodontol 2003;74:1785:17
| Files | ||
| Issue | Vol 8, No 4 (Autumn 2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jcr.v8i4.11074 | |
| Keywords | ||
| Embrasures Interdental papilla Food lodgment Papillary height Crown form Esthetics | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Kedia S, Kumathalli K, Sridhar R, Parwani S, Tekade S, Warekar A. Influence of interdental embrasures on interdental papilla. J Craniomaxillofac Res. 2022;8(4):197-209.
