Clinical and Radiographical Evaluation of Papilla Levels Following Two Different Techniques for Second-stage Implant Surgery: A Randomized Clinical Trial

Background: True regeneration of the papilla is not possible around implants. The underlying bone and periodontal biotype have an impact on the development of papillae after placing implant. The study’s purpose was to assess the papilla levels clinically and radiographically utilizing two distinct methods. Aim: The aim of the study was to evaluate the differences between I-shaped and midcrestal incisions for second-stage implant surgery in terms of clinical and radiological results, particularly papillary fill levels, bone crest levels, and soft-tissue health around the peri-implant area. Thirty patients were divided into two groups at random to undergo second-stage implant surgery. Group A underwent an I-shaped incision, whereas Group B underwent a modified roll flap method that preserved the papillae. Materials and Methods: Clinical parameters such as the gingival index, papilla index, Jemt index, gingival biotype, and crestal bone contact point distance were assessed at T0 (at crown placing time) and T1 (3 months after placing the crown). Data analysis was performed with IBM SPSS version 20 software. Descriptive statistics, independent sample t -test, paired t -test, Chi-square test, test of marginal uniformity, and the McNemars Chi-squared test were performed. Results: There was reduced plaque and gingival index scores from baseline to 3 months after crown placement, with increased papillary fill and significant loss of crestal bone is noted in both groups. Intergroup comparison showed no significance in the amount of bone loss and papillary fill. Conclusions: Both techniques were effective in uncovering implants as they can improve and conserve the papillae level. By enhancing the papillae level, both treatment procedures help in the functional and esthetic success of the implant therapy.