I-shaped incisions for papilla reconstruction in second stage implant surgery

Abstract

Purpose: Pink gingival esthetic especially on the anterior teeth has been an important success criterion in implant-supported restoration. Inter-implant papillae are a critical factor for implant esthetics, and various techniques for inter-implant papilla reconstruction have been introduced. The aim of this study is to suggest and evaluate a surgical technique for reconstructing inter-implant papillae.

Methods: A 28-year-old man had an implant placed on the #13 and #14 area. Four months after implant placement, a second stage surgery was planned for inter-implant papilla reconstruction. At the time of the abutment connection, I-type incisions were performed on the #13i & #14i area followed by full-thickness flap elevation and connection of a healing abutment on underlying fixtures without suture.

Results: Two weeks after the second stage implant surgery, soft tissue augmentation between the two implants was achieved.

Conclusions: I-shaped incisions for papilla reconstruction performed during the second stage implant surgery were useful for inter-implant papilla reconstruction and showed a good esthetic result.

Keywords: Dental esthetics; Dental implants; Dental papilla.

Figure 1

Preoperative panoramic view. Residual root on #13 is observed.

Figure 2

Four months after implant placement: facial view.

Figure 3

Four months after implant placement: occlusal view.

Figure 4

Schematic drawing of I-type incision. Labial horizontal incision: 0.5-1 mm inside from the border of implant. Vertical incision: middle line. Palatal horizontal incision: border of implant.

Figure 5

I-incision on #13i.

Figure 6

Healing abutment connection on #13i.

Figure 7

I-incision on #14i.

Figure 8

Healing abutment connection on #14i: occlusal view.

Figure 9

Healing abutment connection on #14i: facial view.

Figure 10

Two weeks after second-stage surgery: occlusal view.

Figure 11

Two weeks after second-stage surgery: facial view.