The Interproximal height of Bone: A Guidepost to Esthetic Strategies and Soft Tissue Contours in Anterior Tooth Replacement

Review and follow-up to the 1998 article The literature, through the concept of the “biological width”, outlines the minimum soft tissue dimension that is physiologically necessary to protect and separate the osseous crest from a healthy gingival margin surrounding teeth and the peri-implant environment. This approximately 3mm minimum zone is comprised of roughly 1mm for the connective tissue zone immediately adjacent to the osseous crest, 1mm for the junctional epithelium and 1mm for sulcular epithelium. In contrast to assuring the minimum biological dimensions, the therapeutics of soft tissue esthetics, by necessity, are more concerned with developing the maximum achievable and maintainable soft tissue dimensions. Clinicians have long had access to an array of effective surgical techniques for maximizing muco-gingival and ridge dimensions through the utilization soft tissue and osseous grafts1-5.The regeneration of interproximal papillae deficiencies, however, has not enjoyed the same degree of success. Tarnow et al. (1992)6 and Salama et al. (1998)7 have explained this discrepancy by illuminating the key rol