Influence of surgically assisted rapid maxillary expansion on the interdental papilla height of maxillary central incisors

PURPOSE: To evaluate the influence of orthodontic treatment with surgically assisted rapid maxillary expansion (SARME) on the interdental papilla height of maxillary central incisors. METHODS: In this retrospective study, patients who completed orthodontic treatment including SARME at the Radboud University Medical Center Orthodontic Department before December 2019 were included. Frontal intraoral photographs taken before (T1) and after completion of treatment (T2) were examined to determine the papilla height between the maxillary central incisors using the Jemt classification. The difference between the Jemt classification at T1 and T2 (∆Jemt) was defined as the primary outcome variable. Secondary outcome variables were gender, age, treatment duration, type of expansion appliance, maximal central diastema during expansion, pretreatment overlapping between the central incisors, gingival biotype, crown morphology and the distance between the bone crest and incisal contact point. Kappa statistics and paired t‑tests were used to determine reliability of the measurements. Pearson's Χ(2) test and independent t‑tests were used to compare the variables between the groups of patients with and without papillary recession. Finally, multiple logistic regression analysis was performed. RESULTS: In all, 93 patients fulfilled the inclusion criteria and were included in the study. The Jemt score worsened for 30 patients (32%) between T1 and T2, indicating the occurrence of papillary recession. Incisal overlapping, crown morphology, small width to length ratio, increasing age and an increasing distance between crestal bone and the incisal contact point were factors associated with papillary recession. CONCLUSION: After orthodontic treatment including SARME, one third of patients exhibited recession of papilla height of the maxillary central incisors