Papilla Proportions in the Maxillary Anterior Dentition

Stephen J. Chu, DMD, MSD, CDT*
Dennis P. Tarnow, DDS**
Jocelyn H.-P. Tan, DDS***
Christian F. J. Stappert, DDS, MS, PhD****

Two hundred forty interdental papilla sites in 20 healthy patients were investigated. Interdental papilla heights of maxillary anterior teeth were measured from the gingival zenith, along with clinical crown lengths.

Percentages of papilla height to crown length were computed and defined as papilla proportion, mesial papilla proportion (MPP), and distal papilla proportion (DPP). Mean interdental papilla heights of maxillary anterior teeth were 4 mm mesially and 4.1 mm distally. Mean MPP was 42% (n = 120), and mean DPP was 43% (n = 120). No significant differences were found between MPP and DPP for maxillary incisors (P≥.5).

Canines demonstrated a trend toward increased distal papilla heights. Papilla proportions were approximately 40% for all tooth groups. A more apical position of distal papilla heights from anterior to posterior teeth, mentioned in the literature, was not confirmed by the present data. An interdisciplinary team approach to multidisciplinary therapies in esthetic restorative treatment has become commonplace in the dental profession.

The perception of dental esthetics, however, varies significantly among dental professionals, although substantial efforts have been made to establish common standards. Several textbooks have sought to help guide clinicians in optimizing esthetic results. Rufenacht,for example, discussed the fundamentals of esthetics and described procedures for integrating dental restorations into the individual facial composition with respect to biologic and functional requirements, not merely esthetics.

Goldstein attempted to establish principles to help practitioners achieve esthetic results and develop a rationale for esthetic dental treatment.

Fradeani4 described a systematic approach to esthetic analysis, evaluation, and treatment based on general principles and illustrated that the height of the interdental papillae decreased from anterior to posterior teeth. Despite these efforts, there is still little consistency among clinicians’ perspectives of what constitutes an esthetic smile.

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