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Titanium-reinforced interdental peaks as a simple method for papilla preservation.

Esthetic failure within the esthetic zone can be caused by the presence of interdental black triangles due to the loss of interdental papillae. The position of the osseous crest represents the main determinant for the papilla height, and, therefore, interdental bone peaks should be preserved both during and following dental treatment. Osseointegrated titanium implants maintain bone levels at the site where they have been inserted, even when left non-loaded. This property of osseointegrated titanium implants can be applied to preserve interdental bone peaks. The technique described in this case report illustrates how small titanium bars were surgically inserted within the interdental osseous peaks in order to prevent bone resorption and maintain papilla height. Clinical measurements between a fixed reference point and the papilla tips were performed over a 12-month period. A positive gingival architecture was created and maintained even following multiple tooth extractions in the esthetic zone.