AIM: Loss of implant papilla is one of the more troubling dilemmas in implant dentistry. The "black triangle" around the implant-supported restoration causes not only phonetic difficulties and food impaction but also unpleasant esthetics. This is considered to be a failure in today's implant therapy standards. As a consequence, many techniques have been developed to either preserve or regenerate the interimplant soft tissue. It is the purpose of this article to examine factors that may affect the appearance of the peri-implant papilla. MATERIALS: MEDLINE search was used to identify articles published through September 2007 related to implant esthetics as interimplant papillae. RESULTS: Factors such as crestal bone height, interproximal distance, tooth form/shape, gingival thickness, and keratinized gingival width have all been identified to influence the appearance of the interimplant papillae. In addition, many techniques/materials have been successfully used in promoting interimplant papillae formation. CONCLUSION: This article presents a comprehensive review of factors that may influence the interimplant papillae and illustrates techniques used in attempting to recreate/correct this challenging problem in implant dentistry.
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