Variables Affecting the Gingival Embrasure Space in Aesthetically Important Regions: Differences between Central and Lateral Papillae

Marco Montevecchi1, Vittorio Checchi2, Laura Piana1, Luigi Checchi1, *
1 Department of Periodontology and Implantology, School of Dentistry, Alma Mater Studiorum - University of Bologna, Bologna, Italy
2 Department of Odontostomatological, Orthodontic and Surgical Sciences, Second University of Naples, Naples, Italy

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© Montevecchi et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Periodontology and Implantology, School of Dentistry, Alma Mater Studiorum, University of Bologna. Via S. Vitale 59, 40125 Bologna, Italy; Tel: +39/0512080115; Fax: +39/0514391718; E-mail:


This study evaluated different variables to determine their role in the appearance of the central and lateral upper jaw papillae. 292 interdental embrasures were examined. Personal variables were: age, smoke, and use of interproximal hygiene devices. The clinical characteristics were: tooth shape, periodontal biotype and papilla appearance. Radiographic measurements were: root to root distance at the cemento-enamel junction (horizontal distance), and bone crest to interdental contact point distance (vertical distance). The papilla recession increased with patient age. The horizontal distance of the central papilla was always greater (up to 1 mm) than that of the other papillae. The vertical distance of the central papilla was greater (up to 2 mm) than that of the other papillae for each class except for the normal one (Nordland & Tarnow classification). For vertical distances ≤5 mm, papillae were almost always present; for distances up to 6 mm, the lateral papillae belonging to the normal class disappeared, while the central papilla remained in 11% of cases; central papillae of class 1 were present in larger proportions until a vertical distance of 8 mm. The present observational study shows that differences on clinical and radiographic determinants do exist between central and lateral papillae. This variance should be strictly taken in account for a harmonious and stable treatment outcome on this highly aesthetic area.

Keywords: Interdental papilla, soft tissue, aesthetic, measurements, radiography.