Minimally invasive therapy for reconstruction of lost interdental papilla by using injectable hyaluronic acid filler

Interdental papilla reconstruction: a systematic review

“…Repeated at 3 weeks No control group Black triangle height reduction (mm and %) using digital photos and probing measurements 3 weeks 0.17 mm 8% 3 months 0.83 mm 39% 6 months 0.62 mm 29% 6 months 5) Awartani and Tatakis [ 8 ] Case series Prospective King Saud hospital, Saudi Arabia single setting 10 patients 17 defects 10 females 36.4 years 1 smoker (was excluded) 1 No Yes HA gel injection repeated at 21 days and 42 days No control group Percentage reduction of black triangle using clinical photographs and image analysis software Black triangle area 0.71 ± 0.74 Reduction 41 ± 37% 6 months 6) Kapoor and Dudeja [ 28 ] Case series Prospective SGT university hospital, Delhi, India Single setting 6 patients 7 defects 4 female 2 male 37.5 years Non-smokers 0 No Yes HA dermal filler gel injection, repeated at 3 weeks and 3 months No control group Percentage gain in interdental papilla fill 88.2% Gain in interdental papilla height 3.3 mm 3 months 7) Lee et al [ 32 , 33 ] Case series Chosun university hospital, South Korea Single setting 10 patients 43 defects 6 female 4 male 32 years Smoking status not reported 0 No Yes HA gel injection (Teosyal Puresense Global ActionVR, Teoxane, Geneva) Switzerland). Repeated up to 5 times every 21 days until no black triangle visible Interdental papilla reconstruction rate (%), decreases in black triangle area (mm 2 ), width (mm), height (mm) Reduction in: Black triangle area 0.20mm 2 Black triangle height 0.71 mm Black triangle width 0.32 mm Interdental papilla reconstruction rate 92.55% 6 months 8) Lee et al[ 32 , 33 ] Case series Prospective Chosun University Hospital, South Korea Single setting 13 patients 65 sites [ 49 ] 7 female 6 male ...…”

“…Repeated up to 5 times every 21 days until no black triangle visible Interdental papilla reconstruction rate (%), decreases in black triangle area (mm 2 ), width (mm), height (mm) Reduction in: Black triangle area 0.20mm 2 Black triangle height 0.71 mm Black triangle width 0.32 mm Interdental papilla reconstruction rate 92.55% 6 months 8) Lee et al[ 32 , 33 ] Case series Prospective Chosun University Hospital, South Korea Single setting 13 patients 65 sites [ 49 ] 7 female 6 male 32 years Smoking status not reported 8 sites excluded No Yes HA gel injection repeated up to 5 times every 21 days until no black triangle visible Interdental papilla reconstruction rate: percentage change of black triangle area Reduction in: Black triangle area 0.21mm 2 Black triangle height 0.70 mm Black triangle width 0.30 mm Interdental papilla reconstruction rate 88.8% 6 months 9) Mansouri et al [ 35 ] Case series Islamic Azad University Hospital, Iran Single setting 11 patients 21 defects 8 females 3 males 37.5 ± 14.4 years Non smokers 6 months No Yes HA injections repeated 3 times every 3 weeks Gingival embrasure space calculated using clinical photographs based on pixel size using a formula Increase in papilla reconstruction ranging from 20–100% with mean (percentage ± standard deviation) 47.33 ± 20.20% at 6 months 10) Ni et al [ 43 ] Case series Prospective Shanghai Ninth People’s Hospital, China Single setting 8 patients 22 defects 8 females 41.6 years Non-smokers 0 Yes Yes HA gel injection, repeated at 3 weeks and 6 weeks No control group Clinical and photographic measurements and DIGIMIZER, height of gingival papilla and area of black triangle Height of papillae increased by 0.4 mm Area of black triangle reduced by 0.36mm 2 12 months 11) Patil [ 47 ] Case series Maharashtra University Hospital, India Single setting ...…”

“…Çankaya et al [ 11 ] repeated the HA injections every 3 weeks but the end-point of this was not made clear. Pitale et al [ 49 ] reported only 1 application of the HA injection. In the methodology reported by Singh et al [ 62 ], the HA injection was repeated after the first application at the second and third weeks.…”

“…The loss of the interdental papilla can cause the appearance of black triangles which can be aesthetically displeasing and lead to food impaction and phonetic problems. This can lead to a negative impact in the oral health–related quality of life and self-esteem for the patient [ 49 ].…”

Effectiveness of Non-Surgical Procedures for the Treatment of Black Triangle Cases in the Aesthetic Zone on the Height of the Interdental Papilla: Narrative Review

“…The results showed statistically significant differences from baseline to 3 and 6 month intervals. 20,21,22 The case series research reported by However, the treatments mentioned above may not provide satisfactory and or predictable results. 2 A newer and non-invasive approach for the treatment of black triangle cases in the aesthetic area is the application of hyaluronic acid, i-PRF and photobiomodulation therapy which have shown promising results in recent years.2,16,29…”