Abutment-Supported Papilla: A Combined Surgical and Prosthetic Approach to Papilla Reformation

Restoration of lost interdental papilla remains one of the most challenging goals for clinicians. When a single tooth is replaced with an implant, the papilla between the tooth and the implant can often be maintained or predictably reconstructed as long as the periodontal attachment and bone of the adjacent tooth is preserved. However, if the periodontal support is compromised on the neighboring natural tooth, the papilla will often be deficient or missing. This article presents a multidisciplinary treatment approach to regenerate the interdental papilla between an implant and a periodontally compromised tooth using surgical procedures and a customized abutment. Specifically, an abutment with modified subgingival contours is used to enhance support of the surgically reformed papilla.