Change of Incisive Papilla Height Due to Orthodontic Movement: An Evaluation in Study Models and Three-Dimensional Images

Abstract

The presence of gingival papillae in the anterior maxilla is essential to the aesthetics of the smile. The aim of this study was to evaluate alterations in the height of the upper central incisive papilla, before and after orthodontic movement, using study casts and cone beam computed tomography (CBCT). Sixteen patients between the ages of 13 and 18 years underwent orthodontic treatment. The height of the papillae was calculated in both initial and final study casts by drawing a horizontal line tangent to the zenith of the central incisors and inscribing a vertical line perpendicular to the horizontal line. Papilla height was defined as the distance from the tip of the papilla to the point of intersection between the two lines. Initial and final (after orthodontic treatment) CBCT images were analyzed, and the height of interproximal papillae was calculated by measuring the distance from the tip of the papilla to the alveolar bone crest. This measurement was performed in both sagittal and coronal plane views. Data were statistically analyzed using the Student t test. The level of significance was 5%. Initial mean papilla height was 4.6 ± 0.8 mm, and the final value in study casts was 4.3 ± 1.2 mm; there was not a statistically significant difference between initial and final values (p = 0.309). In the CBCT coronal sections, initial mean papilla height was 3.5 ± 1.2 mm vs. 3.1 ± 0.7 mm after treatment (p = 0.094); again, no statistically significant differences were observed. In the sagittal plane, there was a significant difference (p = 0.05) between initial (3.7 ± 1.1 mm) and final (3.1 ± 0.6 mm) mean papilla height. According to our findings, and to the different measuring techniques employed, the height of the papilla changed little as a result of orthodontic therapy.