Papilla and gingival outcomes in implant‐rehabilitated patients with oligodontia: A retrospective study

Abstract

BackgroundOligodontia is a rare condition characterized by the absence of at least 6 teeth. Implant‐supported prosthetic rehabilitation offers a reliable solution for affected patients. However, the unique periodontal traits of oligodontia raise questions about the best prosthetic approach for papilla reconstruction. This retrospective study aims to assess papilla and gingival esthetics in implant‐supported rehabilitation of patients with oligodontia. The study compared 3 prosthetic rehabilitation options: adjacent implants, bridges, and cantilevers.MethodsTwenty‐seven patients with oligodontia who received implant‐supported treatment participated in the study. Esthetic evaluations were performed using the pink esthetic score (PES) for teeth, implants, and pontics, while the papilla index score (PIS) was used to assess papilla appearance. Interdental sites were divided into 3 groups: control (papilla between teeth), tooth–papilla (papilla between tooth and pontic or implant), and implant–papilla (papilla between implants or between implant and pontic).ResultsThe study included 292 teeth, 116 implants, 27 pontics. The mean follow‐up for implants was 36.0 ± 19.8 months and for prosthetic rehabilitation, 26.7 ± 20.8 months. PES was highest for teeth (13.5 ± 1.04), followed by implants (12 ± 1.97) and pontics (11.9 ± 2.04) (p < 0.001). PIS demonstrated a difference (p < 0.001) between control (2.72 ± 0.64), tooth–papilla (2.17 ± 0.86), and implant–papilla (1.26 ± 0.84). No statistical difference was observed between the 2 implants and between an implant and pontic.ConclusionNatural teeth consistently demonstrated superior esthetic outcomes in PES. However, papilla regeneration was more successful when a tooth was involved in the prosthetic restoration. Reversely, when required, 2 single‐crown implant‐supported and cantilever implant‐supported are similarly effective in papilla outcomes.Plain language summaryOligodontia, a rare condition characterized by the absence of at least 6 teeth, presents challenges in achieving natural‐looking dental restorations. This study evaluated the esthetic outcomes of implant‐supported prosthetic treatments in 27 patients with oligodontia, focusing on interdental papilla reconstruction. Three rehabilitation methods were compared: adjacent implants, bridges, and cantilevers. Esthetic assessments used the pink esthetic score (PES) for teeth, implants, and pontics, and the papilla index to measure papilla quality. Results showed that natural teeth achieved the highest PESs, followed by implants and pontics. For papilla quality, sites involving natural teeth scored better than those between 2 implants or between an implant and a pontic. Our findings emphasize that natural teeth presence in prosthetic designs improves esthetic outcomes, particularly in papilla regeneration. However, when incorporating natural teeth is not an option, adjacent crown‐supported implants and cantilever‐supported implants offer equally effective solutions in esthetic outcomes.