head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2020, vol. 26, issue4
Subject Area: Dental Medicine
-
DOI: 10.5272/jimab.2020264.3408
Published online: 02 November 2020

Original article

J of IMAB. 2020 Oct-Dec;26(4):3408-3415
MINIMALLY INVASIVE RECONSTRUCTION OF DEFICIENT PAPILLAE WITH HYALURONIC ACID - TREATMENT PROTOCOL AND 6-MONTHS RESULTS
Elena FirkovaORCID logo Corresponding Autoremail,
Department of Periodontology and Oral Diseases, Faculty of Dental Medicine, Medical University – Plovdiv, Bulgaria.

ABSTRACT:
Increasing demands of patients for gingival esthetic and management of deficient papillae in the anterior region had stimulated minimally invasive techniques for papilla reconstruction with biological molecules.
Purpose: To evaluate the effect of hyaluronic gel injections in deficient papillae and monitor the results for a 6-months period.
Materials and methods: 57 class I and class II deficient papillae were included. 4 weeks after scaling and root planning hyaluronic acid gel was injected in the papillae. The injections were repeated in 20 days.  Measurements of papilla height were done on the clinical photographs. The distance between the contact point (complete fill of interproximal space) to the most coronal level of the visible gingival margin was measured before treatment and on months 1, 3 and 6 and compared to baseline.
Results: There was a statistically significant change in the papilla level and fill of the interproximal space, ranging from 59% papilla gain on the first month, 72% to the third month and 77% on 6 months. Conclusion: Hyaluronic acid gel is a reliable method for mini-invasive papilla augmentation, especially in class I and class II papilla deficiencies.

Keywords: deficient papilla, minimally invasive reconstruction, hyaluronic acid,

pdf - Download FULL TEXT /PDF 2965 KB/
Please cite this article as: Firkova E. Minimally invasive reconstruction of deficient papillae with hyaluronic acid - treatment protocol and 6-months results. J of IMAB. 2020 Oct-Dec;26(4):3408-3415.
DOI: 10.5272/jimab.2020264.3408

Corresponding AutorCorrespondence to: Elena Firkova, Department of Periodontology and Oral Diseases, Faculty of Dental Medicine, Plovdiv, Bulgaria; E-mail: elenafirkova@yahoo.com

REFERENCES:
1. Kurth JR, Kokich VG. Open gingival embrasures after orthodontic treatment in adults: prevalence and etiology. Am J Orthod Dentofacial Orthop. 2001 Aug;120(2):116-23. [PubMed]
2. Pini Prato GP, Rotundo R, Cortellini P, Tinti C, Azzi R. Interdental papilla management: a reviewand classification of the therapeutic approaches. Int J Periodontics Restorative Dent. 2004 Jan;24(3):246-55. [PubMed]
3. Ziahosseini P, Hussain F, Millar BJ. Management of gingival black triangles. Br Dent J. 2014 Nov; 217(10):559-63. [PubMed]
4. Cunliffe J, Pretty I. Patient's ranking of interdental “black triangles” against other common aesthetic problems. Eur J Prosthodont Restor Dent. 2009 Dec;17(4):177-81. [PubMed]
5. Kokich Jr. VO, Kiyak HA, Shapiro PA. Comparing the perception of dentists and lay people to altered dental esthetics. J Esthet Dent. 1999; 11(6):311-24. [PubMed]
6. Kolte AP, Kolte RA, Mishra PR. Dimensional influence of interproximal areas on existences of interdental papillae. J Periodontol. 2014 Jun;85(6):795-801. [PubMed]
7. Singh VP, Uppoor AS, Nayak DG, Shah D. Black triangles dilemma and its management in esthetic dentistry. Dent Res J (Isfahan). 2013 May;10(3):296-301. [PubMed]
8. Nordland WP, Tarnow DP. A classification system for loss of papillary height. J Periodontol.1998 Oct;69(10):1124-6. [PubMed]
9. Tarnow DP, Magner AW, Fletcher P. The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla. J Periodontol. 1992 Dec;63(12):995-6. [PubMed]
10. Al Ahmari F. Reconstruction of lost interdental approach: a review of nonsurgical approaches. IOSR J Dent Med Sci. 2018 Feb;17(2-10):59-65.  [Internet]
11. Cardaropoli D, Re S, Corrente G. The Papilla Presence Index (PPI): a new system to assess interproximal papillary levels. Int J Periodontics Restorative Dent. 2004 Oct;24(5):488-92. [PubMed]
12. Beagle JR. Surgical reconstruction of the interdental papilla: case report. Int J Periodontics Restorative Dent. 1992; 12(2):145-51. [PubMed]
13. Tarnow DP. Semilunar coronally repositioned flap. J Clin Periodontol. 1986 Mar;13(3):182-5. [PubMed]
14. Carnio J. Surgical reconstruction of interdental papilla using an interposed subepithelial connective tissue graft: a case report. Int J Periodontics Restorative Dent. 2004 Feb;24 (1):31-7. [PubMed]
15. Cortellini P, Prato GP, Tonetti MS. The modified papilla preservation technique. A new surgical approach for interproximal regenerative procedures. J Periodontol. 1995 Apr;66 (4) :261-6. [PubMed]
16. Nordland WP, Sandhu HS, Perio C. Microsurgical technique for augmentation of the interdental papilla: Three case reports. Int J Periodontics Restorative Dent. 2008 Dec;28 (6):543-9. [PubMed]
17. Al-Khateeb R, Prpic J. Hyaluronic acid: the reason for its variety of physiological and biochemical functional properties. Appl Clin Res Clin Trial Regul Affairs. 2019; 6(2):112-159. [Crossref]
18. Becker W, Gabitov I, Stepanov M, Kois J, Smidt A, Becker BE. Minimally invasive treatment for papillae deficiencies in the esthetic zone: a pilot study. Clin Implant Dent Relat Res. 2010 Mar;12(1):1-8. [PubMed]
19. Awartani FA, Tatakis DN. Interdental papilla loss: treatment by hyaluronic acid gel injection: a case series. Clin Oral Investig. 2016 Sep;20(7):1775-80. [PubMed]
20. Tanwar J, Hungund SA. Hyaluronic acid: hope of light to black triangles. J Int Soc Prevent Community Dent. 2016 Sep-Oct;6 (5):497-500. [PubMed]
21. Mansouri SS, Ghasemi M, Salmani Z, Shams N. Clinical application of hyaluronic acid gel for reconstruction of interdental papilla at the esthetic zone. J Islamic Dent Assoc Iran. 2013; 25(2):152-157. [Internet]
22. Gottfert F, Striegel M. Hyaluronic acid at its Best. Minimally invasive HA-based treatment concepts for modern dentistry. [Internet]
23. Abdelraouf SA, Dahab OA, Elbarbary A, El-Din AM, Mostafa B. Assessment of hyaluronic acid gel injection in the reconstruction of interdental papilla: a randomized clinical trial. Open Access Maced J Med Sci. 2019 Jun 14;7(11):1834-1840. [PubMed] [Crossref]. 

Received: 28 October 2019
Published online: 02 November 2020

back to Online Journal