Factors affecting soft tissue recession around anterior maxillary single-tooth implants

Abstract

Background: Peri-implant soft tissue recession is a major esthetic concern for the anterior implants. The aim of this study was to determine factors that affected the facial marginal recession and papillary recession around single-tooth implants in the anterior maxilla. Methods: Forty single-tooth implants in the anterior maxilla were studied. Variables possibly associated with soft tissue recession were obtained from clinical measurements, study models, peri-apical radiographs, and computerized tomograms. The Fisher’s exact test, analysis of variance, and binary logistic regression analysis were used to determine the influence of each factor on facial marginal recession and papillary recession. Results: The majority of the implants (75%) replaced the upper central incisors. The mean facial marginal recession was 0.5 ± 0.9 mm. Eighty-nine percents of the implants had more than half of papilla fill. Facial marginal recession was influenced by many factors. Increased risk of facial marginal recession was significantly associated with thin peri-implant biotype, proclined implant fixture angle, more apical level of facial bone crest, increased distance from contact point to bone crest, contact point to platform, and contact point to implant bone. Thin biotype was the most significant factor in determining the presence of facial marginal recession. Increased distance from contact point to bone crest was the only factor significantly associated with increased risk for papillary recession. Conclusions: Papillary recession around single-tooth implants in the anterior maxilla was mainly influenced by the interproximal bone crest level of the adjacent tooth. Facial marginal recession, on the other hand, was affected by multiple factors including, the peri-implant biotype, the facial bone crest level, the implant fixture angle, the interproximal bone crest level, the depth of implant platform, and the level of first bone to implant contact.