Glossary

The papilla is the soft tissue that occupies the interproximal space confined by adjacent crowns in contact. In relation to oral anatomy, the term may apply to interdental papilla which is a portion of the free gingiva that occupies the interproximal space and which is confined by the adjacent teeth that are in contact. It may also refer to interimplant papilla. This is the soft tissue that occupies the interproximal space while being confined by adjacent implant-supported fixed partial dentures which are in contact. In either case, the papilla can become damaged or inflamed due to poor dental hygiene or gingivitis and may recede. If this occurs, oral surgery may be required to restore the papilla between the teeth and restore good oral health. If inflammation and recession of the papilla are taking place due to gingivitis, the condition can be more serious as immediate intervention is required to prevent the development of periodontitis.

Papilla preservation is a surgical and prosthetic measure taken to maintain and/or reduce trauma to the interproximal tissue. One of the negative side effects of periodontal surgery is the reduced papillary height and papillary shrinkage that can lead to the exposure of underlying tissues. To prevent this, a papilla preservation technique can be used by the surgeon to help the papilla maintain a more aesthetic look for the patient’s comfort and confidence. One such technique utilizes the papilla preservation flap method in which no incision is made along the facial surface of the interdental papilla. The modified papilla preservation flap method is another technique that may be utilized following periodontal surgery and involves incisions made around the teeth next to the surgery location. These types of papilla preservation techniques allow patients to enjoy both the benefits of the surgery or implant as well as the appearance of the affected area following surgery.

Papilla reformation is the spontaneous reformation of the interproximal papilla following the establishment of a contact point and the management of the interproximal prosthetic papillary space. The term also refers to the re-establishment of the lost interproximal papilla by surgical means. Following the placement of an implant, the papilla between the neighboring tooth and the implant may be lost or significantly reduced if the neighboring tooth’s periodontal attachment is compromised. Papilla may be regenerated through papilla reformation by using a combination of hard and soft tissue grafting procedures. Bone grafting to replace missing or weakened bone between the teeth is an especially essential step that is often required for papilla reformation to take place. Another possible pathway to papilla reformation involves the use of growth factors used with bone grafting procedures. Papilla reformation is often a challenging process and therefore, proper patient preparation should take in an effort to avoid the loss of interproximal papilla.

The dental papillae is an accumulation of mesenchyme that fills the cavity of each tooth and is necessary for the formation of both dental pulp and dentin, which is firmer than bone but not as hard as the outer layer of enamel on the teeth. A papilla-sparing incision is used in dental implantology to place a permanent implant when the surgeon needs to augment soft or hard tissue to complete the procedure and achieve the patient’s desired aesthetic and functional outcome. This type of incision facilitates the surgeon’s access to bone for dental implant placement, while also restoring impaired gingival and bone architecture. The primary benefit of the papilla-sparing incision technique is that it enables periodontal surgeons to perform procedures without inducting the recession of healthy papillae that are adjacent to the sites being treated. Because papilla is unable to regenerate, preserving it is of the utmost importance during a dental implant procedure.