Peri-implant papilla reconstruction: realities and limitations.

In recent years, esthetic demands in dentistry have been climbing ever higher, driven by an enhanced awareness of beauty and physical appearance. Because gingival esthetics has become an important factor in the overall success of most implant-supported restorations, the loss of the peri-implant papilla leads to an esthetic handicap known as black hole disease. Today, one of the most challenging aspects of periodontal reconstructive surgery is to obtain a predictable peri-implant papilla in the esthetic zone. Starting with the facts about the morphology of the peri-implant tissues, to the various parameters influencing papilla reconstruction around implants, this article gives a brief overview of various papilla preservation and reconstruction techniques around implants.