Clinical assessment of interdental papilla competency parameters in the esthetic zone.

BACKGROUND: Interdental papilla occupies the space between two adjacent teeth. Its contour and health are regarded with utmost importance in esthetic dental therapy. The loss of papillary height can result in open gingival embrasures, phonetic problems, food impaction, and esthetic concerns: therefore in order to prevent its loss and to better understand the challenges of regenerating the lost gingival papillae, it is crucial to recognize the factors that influence papilla form. AIM: The purpose of this study is to evaluate various factors associated with the fill of interdental spaces by gingival papillae MATERIAL AND METHODS: 150 interdental papillae in 30 patients were assessed with clinical and study models. Papilla score (PS), tooth form/shape, gingival thickness, crest bone height, facio lingual thickness and gingival angle were recorded. RESULTS: In the study it was observed that complete papilla fill was associated with bone crest-contact point distance </= 5 mm and crown width: length >/=0.88 while interproximal gingival tissue thickness and gingival angle were significantly higher in competent as compared to incompetent papilla group. CONCLUSION: Interdental papillae appearance was associated significantly with tooth form/shape (CW/CL), crestal bone height, gingival thickness and gingival angle. CLINICAL SIGNIFICANCE: Presence of appropriately positioned interdental papillae in the anterior dentition is essential. Its deficiency leads to complex esthetic and functional problems while its reconstruction poses a formidable challenge. Thus a prior understanding of the various factors that affect its integrity in the anterior region allows for better management of the papillae leading to a more predictable outcome.