When the crown of the tooth #11 is removed (Fig.3, 5 months 3 weeks postop), the distal papilla of #10 appears to be more recessive than the mesial counterpart, probably due to the pre-existing condition (bone loss) and the mesial placement of the implant at the site of #10.  The metal implant (gingival level) and abutment (Fig.3 *) contributes to gingival darkness (Fig.1-4).  In contrast, the implant at the site of #9 is bone level with gold coated abutment.  It causes minimal dark gingiva.

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Xin Wei, DDS, PhD, MS 1st edition 08/17/2014, last revision 01/19/2018