Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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An analysis on the factors responsible for relative position of interproximal papilla in healthy subjects

  • Kim, Joo-Hee (Department of Periodontology, Pusan National University School of Dentistry) ;
  • Cho, Yun-Jung (Department of Periodontology, Pusan National University School of Dentistry) ;
  • Lee, Ju-Youn (Department of Periodontology, Pusan National University School of Dentistry) ;
  • Kim, Sung-Jo (Department of Periodontology, Pusan National University School of Dentistry) ;
  • Choi, Jeom-Il (Department of Periodontology, Pusan National University School of Dentistry)
  • Received : 2013.02.01
  • Accepted : 2013.08.07
  • Published : 2013.08.31
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Abstract

Purpose: This study examined the factors that can be associated with the appearance of the interproximal papilla. Methods: One hundred and forty-seven healthy interproximal papillae between the maxillary central incisors were examined. For each subject, a digital photograph and periapical radiograph of the interdental embrasure were taken using a 1-mm grid metal piece. The following parameters were recorded: the amount of recession of the interproximal papilla, contact point-bone crest distance, contact point-cemento-enamel junction (CEJ) distance, CEJ-bone crest distance, inter-radicular distance, tooth shape, embrasure space size, interproximal contact area, gingival biotype, papilla height, and papilla tip form. Results: The amount of recession of the interproximal papilla was associated with the following: 1) increase in contact point-bone crest, contact point-CEJ, and CEJ-bone crest distance; 2) increase in the inter-radicular distance; 3) triangular tooth shape; 4) decrease in the interproximal contact area length; 5) increase in the embrasure space size; and 6) flat papilla tip form. On the other hand, the amount of gingival recession was not associated with the gingival biotype or papilla height. In the triangular tooth shape, the contact point-bone crest distance and inter-radicular distance were longer, the interproximal contact area length was shorter, and the embrasure space size was larger. The papilla tip form became flatter with increasing inter-radicular distance and CEJ-bone crest distance. Conclusions: The relative position of the interproximal papilla in healthy subjects was associated with the multiple factors and each factor was related to the others. A triangular tooth shape carries a higher risk of recession of the interproximal papilla because the proximal contact point is positioned more incisally and the bone crest is positioned more apically. This results in an increase in recession of the interproximal papilla and flat papilla tip form.

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References

  1. An KY, Lee JY, Kim SJ, Choi JI. Perception of maxillary anterior esthetics by dental professionals and laypeople and survey of gingival topography in healthy young subjects. Int J Periodontics Restorative Dent 2009;29:535-41.
  2. Moskowitz ME, Nayyar A. Determinants of dental esthetics: a rational for smile analysis and treatment. Compend Contin Educ Dent 1995;16:1164, 1166.
  3. Zetu L, Wang HL. Management of inter-dental/inter-implant papilla. J Clin Periodontol 2005;32:831-9. https://doi.org/10.1111/j.1600-051X.2005.00748.x
  4. 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 Periodontol 1992;63:995-6. https://doi.org/10.1902/jop.1992.63.12.995
  5. Kokich V. Adjunctive Role of Orthodontic Therapy. In: Newman MG, Takei HH, Klokkevold PR, Carranza FA. Carranza's clinical periodontology. 10th ed. Philadelphia: WB Saunders; 2006. p.856-70.
  6. Chow YC, Eber RM, Tsao YP, Shotwell JL, Wang HL. Factors associated with the appearance of gingival papillae. J Clin Periodontol 2010;37:719-27.
  7. Chen MC, Liao YF, Chan CP, Ku YC, Pan WL, Tu YK. Factors influencing the presence of interproximal dental papillae between maxillary anterior teeth. J Periodontol 2010;81: 318-24. https://doi.org/10.1902/jop.2009.090361
  8. Chang LC. Assessment of parameters affecting the presence of the central papilla using a non-invasive radiographic method. J Periodontol 2008;79:603-9. https://doi.org/10.1902/jop.2008.070376
  9. Cho HS, Jang HS, Kim DK, Park JC, Kim HJ, Choi SH, et al. The effects of interproximal distance between roots on the existence of interdental papillae according to the distance from the contact point to the alveolar crest. J Periodontol 2006;77:1651-7. https://doi.org/10.1902/jop.2006.060023
  10. Sasaki T, Mizuno S, Matsui T. The height of interdental papilla and interradicular distance in healthy periodontium. Quintessence 2010;15:120-8.
  11. Sasaki T, Mizuno S, Matsui T. Reconstruction of interdental papilla after apically positioned flap. Quintessence 2010; 15:96-103.
  12. Kois JC. Predictable single-tooth peri-implant esthetics: five diagnostic keys. Compend Contin Educ Dent 2004;25: 895-6, 898, 900.
  13. Kurth JR, Kokich VG. Open gingival embrasures after orthodontic treatment in adults: prevalence and etiology. Am J Orthod Dentofacial Orthop 2001;120:116-23. https://doi.org/10.1067/mod.2001.114831
  14. Morris ML. The position of the margin of the gingiva. Oral Surg Oral Med Oral Pathol 1958;11:969-84. https://doi.org/10.1016/0030-4220(58)90137-3
  15. Wheeler RC. Complete crown form and the periodontium. J Prosthet Dent 1961;11:722-34. https://doi.org/10.1016/0022-3913(61)90181-0
  16. Shigeno K. Understand Periodontal Plastic Surgery. In: Shigeno K. Illustrated periodontal plastic surgery. Toyko: Ishiyaku Publishers; 2005. p.290-331.
  17. Ochsenbein C, Ross S. A reevaluation of osseous surgery. Dent Clin North Am 1969;13:87-102.
  18. Seibert J, Lindhe J. Esthetics and Periodontal Therapy. In: Lindhe J. Textbook of clinical periodontology. 2nd ed. Copenhangen: Munksgaard; 1989. p.477-514.
  19. Maynard JG Jr, Wilson RD. Physiologic dimensions of the periodontium significant to the restorative dentist. J Periodontol 1979;50:170-4. https://doi.org/10.1902/jop.1979.50.4.170
  20. Kumari BN, Thiagarajan R, Narayanan V, Devadoss P, Mammen B, Emmadi P. A new technique for root coverage using buccal fat pad: a short case report. Quintessence Int 2010;41:547-9.
  21. Moskow BS, Tannenbaum P, Bloom A. Visualization of the human periodontium using serial thin section contact radiography. J Periodontol 1985;56:223-33. https://doi.org/10.1902/jop.1985.56.4.223
  22. Spear FM. Maintenance of the interdental papilla following anterior tooth removal. Pract Periodontics Aesthet Dent 1999;11:21-8.
  23. Olsson M, Lindhe J, Marinello CP. On the relationship between crown form and clinical features of the gingiva in adolescents. J Clin Periodontol 1993;20:570-7. https://doi.org/10.1111/j.1600-051X.1993.tb00773.x
  24. Claffey N, Shanley D. Relationship of gingival thickness and bleeding to loss of probing attachment in shallow sites following nonsurgical periodontal therapy. J Clin Periodontol 1986;13:654-7. https://doi.org/10.1111/j.1600-051X.1986.tb00861.x
  25. Fu JH, Yeh CY, Chan HL, Tatarakis N, Leong DJ, Wang HL. Tissue biotype and its relation to the underlying bone morphology. J Periodontol 2010;81:569-74. https://doi.org/10.1902/jop.2009.090591
  26. Muller HP, Schaller N, Eger T. Ultrasonic determination of thickness of masticatory mucosa: a methodologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88: 248-53. https://doi.org/10.1016/S1079-2104(99)70123-X
  27. Kan JY, Morimoto T, Rungcharassaeng K, Roe P, Smith DH. Gingival biotype assessment in the esthetic zone: visual versus direct measurement. Int J Periodontics Restorative Dent 2010;30:237-43.
  28. Sanavi F, Weisgold AS, Rose LF. Biologic width and its relation to periodontal biotypes. J Esthet Dent 1998;10:157-63. https://doi.org/10.1111/j.1708-8240.1998.tb00351.x
  29. Olsson M, Lindhe J. Periodontal characteristics in individuals with varying form of the upper central incisors. J Clin Periodontol 1991;18:78-82. https://doi.org/10.1111/j.1600-051X.1991.tb01124.x

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