Variables Affecting the Gingival Embrasure Space in Aesthetically Important Regions: Differences between Central and Lateral Papillae.

Abstract: This study evaluated different variables to determine their role in the appearance of the central and lateral upper jaw papillae. 292 interdental embrasures were examined. Personal variables were: age, smoke, and use of interproximal hygiene devices. The clinical characteristics were: tooth shape, periodontal biotype and papilla appearance. Radiographic measurements were: root to root distance at the cemento-enamel junction (horizontal distance), and bone crest to interden- tal contact point distance (vertical distance). The papilla recession increased with patient age. The horizontal distance of the central papilla was always greater (up to 1 mm) than that of the other papillae. The vertical distance of the central papilla was greater (up to 2 mm) than that of the other papillae for each class except for the normal one (Nordland & Tarnow classification). For vertical distances ␣5 mm, papillae were almost always present; for distances up to 6 mm, the lateral papillae belonging to the normal class disappeared, while the central papilla remained in 11% of cases; central papillae of class 1 were present in larger proportions until a vertical distance of 8 mm. The present observational study shows that differences on clinical and radiographic determinants do exist between central and lateral papillae. This variance should be strictly taken in account for a harmonious and stable treatment outcome on this highly aesthetic area.