Effect of I-Shape Incısıon Technique on Inter-Implant Papilla: A Prospective Randomized Clinical Trial

Effect of I-Shape Incısıon Technique on Inter-Implant Papilla: A Prospective Randomized Clinical Trial

Effect of I-Shape Incısıon Technique on Inter-Implant Papilla: A Prospective Randomized Clinical Trial

Regenerating a predictable inter-implant papilla is the most complex and challenging aspect of implant dentistry. The aim of the study was to compare the efficacy of I shaped incision technique and conventional midcrestal incision technique for interimplant papilla reconstruction in a 6 month clinical trial.

A total of 40 implants were placed in 12 patients. Groups were determined at second stage surgery, I shape technique used in test group and mid-crestal technique used in control group. The clinical parameters, including modified plaque index, modified sulcus bleeding index, probing depth, keratinized tissue level were recorded baseline, 3 and 6 month. The vertical distance between the crests top-contact point was evaluated with digital periapical radiographs at baseline 3 and 6 month. Also the clinical photographs were taken baseline, 3 and 6 month. Two T shaped full-round hexagonal straight filaments, each 5 mm, were used in the taking of standardized images. With these images the ratio of the papilla area in proportion to the embrasure area and the papilla classification was measured. Non-parametric test were used for statistically analysis.

In the control group second stage surgery was made using the conventional method, midcrestal technique.

The clinical photographs were taken baseline, 3 and 6 month. Two T shaped full-round hexagonal straight filaments, each 5 mm, were used in the taking of standardized images.

Crestal bone loss was measured on digital radiographs at baseline, 3 and 6 month with a Java program me (Image-J 3.0 NIH, Bethesda, USA)

The change of probing depth between baseline, 3 and 6month. Probing depth was measured with a plastic periodontal probe (mm)

Modified bleeding index was measured baseline, 3 and 6 month. Presence of bleeding on probing were performed at four sites of implants.

Modified plaque index was measured baseline, 3 and 6 month. Presence of plaque index was performed at four sites of implants.

Inter-implant vertical distance between the crests top-contact point was also evaluated with digital periapical radiographs.

Inclusion Criteria: No sistemic condition, and age > 18 years, healthy soft tissue (bleeding on probing (BOP) ≤ 20%, Plaque Index ≤ 15%, in a need of at least two collateral implants in the maxilla from second premolar to second premolar sufficient keratinized tissue no bone augmentation procedures before implant placement use of tobacco 10N ≥ cigarettes daily sufficient distance between opposite occluding dentition at the proposed implant sites Exclusion Criteria: history of aggressive periodontitis, systemic diseases such as diabetes pregnant or lactating women radiation therapy in the head and neck area wihtin the previous 12 months, heavy smokers bruxism.