Tissue Stability following Soft-tissue Augmentation and Zirconia Prosthesis: A 6 Years Follow-up

Background: ‘Reconstructive esthetic implant therapy’ is a term evolved in the ever-demanding age of oral implantology today. Maintaining the critical factor in this delicate balance of the gingival/pink esthetics is the periimplant papilla. Its presence being a major esthetic achievement and its loss leads to tremendous esthetic handicap known as ‘black hole disease’. This case report addresses this fascinating yet challenging aspect of reconstruction of periimplant papilla through a novel technique. Methods: A 38-year-old patient presented for replacement of missing tooth. Complete oral and periodontal examination, orthodontic intervention to prepare the implant site was undertaken. Preoperative soft-tissue assessments were done. A modified palatal roll technique was performed for reconstruction of the papillary architecture. Zirconia prosthesis was fabricated and the pink esthetic score (PES) around the prosthesis was calculated. Results: An appreciable PES score around the prosthesis complete fill of the interproximal papilla and buccal soft tissue augmentation resulted from this technique.