Subperiosteal Papilla Augmentation With a Non–Animal‐Derived Hyaluronic Acid Overlay Technique

Abstract

Introduction Loss of the interdental papilla, leading to the formation of black triangular spaces just below the contact area of adjacent teeth, is one of the most challenging periodontal conditions to treat and often requires an interdisciplinary approach by the periodontist, restorative dentist, and orthodontist. Although these “black triangles” may appear quite small from a clinician's standpoint, they can have a significant impact on oral health satisfaction for patients. This case series illustrates a novel minimally invasive approach to restore interdental papilla deficiencies. Case Presentation Four interdental papilla defects were treated in three females. No patients were lost to follow‐up over 6 months. The surgery consisted of a horizontal incision placed apical to the area of papillary loss in the alveolar mucosa just beyond the mucogingival junction. An interdental subperiosteal tissue space was then created by tunneling toward and under the dental papilla. Once adequate release was achieved, dermal filler was administered into and underneath the deficient papilla. The papillary margins were then sealed with cyanoacrylate and additional dermal filler was injected as needed to achieve ideal papillary fill. Six months after treatment there was an improvement in patient‐satisfaction regarding papilla fill demonstrated by a mean increase in visual analogue scale (VAS) measurements of 62.46%. Mean papilla fill was 1.75 mm. Conclusion This surgical technique demonstrates the restoration of deficient interdental papillae between teeth and implants, and perhaps as importantly, a considerable improvement in patient‐based outcomes quantified through VASs.

Interproximal attachment gain: The challenge of periodontal regeneration

“…14,19 The techniques that have been described for attempting reconstructing of the interproximal attachment loss have merely focused on the soft tissue component. Papilla reconstruction has been described with the use of soft tissue grafts or substitutes (connective tissue graft [CTG] or acellular dermal matrix), 6,20,21 hyaluronic acid, 22,23 platelet-rich fibrin, 24,25 cultured and expanded autogenous fibroblast injections, 8 stem cell therapy, 26 and photobiomodulation therapy (Fig. 1).…”

O uso do ácido hialurônico associado ao fechamento de diastema para tratamento de black spaces: estudo de caso clínico

“…Nesse sentido, Spano SJ, et al (2020) descreveram que a reconstrução papilar é um dos tratamentos periodontais mais difíceis e desafiadores. Isso ocorre porque a papila interdental é uma área pequena e frágil com pouco suprimento sanguíneo que parece ser o principal fator limitante em todas as técnicas cirúrgicas e de aumento com o objetivo de reconstruir a papila interdental.…”

Reconstrucción de la papila interdental con ácido hialurónico. Artículo de Revisión Corto

“…Uno de los principales problemas por los cuales los pacientes acuden a consulta odontológica, es la pérdida de la papila interdental y presencia de triángulos negros [1]. Esta pérdida de la papila interdental a más del problema estético provoca retención de alimentos y problemas fonéticos al permitir el paso del aire y saliva [2,3].…”

“…María Cristina Luna Pesántez 1 , Eduardo Sebastián Cáceres Montalván 1 , Jacinto José Alvarado-Cordero 1 .…”