J Periodontal Implant Sci.  2016 Aug;46(4):277-287. 10.5051/jpis.2016.46.4.277.

The association between radiographic embrasure morphology and interdental papilla reconstruction using injectable hyaluronic acid gel

• Lee WP
• Seo YS
• Kim HJ
• Yu SJ
• Kim BO

• KMID: 2350028
• DOI: http://doi.org/10.5051/jpis.2016.46.4.277

Abstract

PURPOSE
The purpose of this study was to evaluate the clinical efficacy of enhancing deficient interdental papilla with hyaluronic acid gel injection by assessing the radiographic anatomical factors affecting the reconstruction of the interdental papilla.
METHODS
Fifty-seven treated sites from 13 patients (6 males and 7 females) were included. Patients had papillary deficiency in the upper anterior area. Prior to treatment, photographic and periapical radiographic standardization devices were designed for each patient. A 30-gauge needle was used with an injection-assistance device to inject a hyaluronic acid gel to the involved papilla. This treatment was repeated up to 5 times every 3 weeks. Patients were followed up for 6 months after the initial gel application. Clinical photographic measurements of the black triangle area (BTA), height (BTH), and width (BTW) and periapical radiographic measurements of the contact point and the bone crest (CP-BC) and the interproximal distance between roots (IDR) were undertaken using computer software. The interdental papilla reconstruction rate (IPRR) was calculated to determine the percentage change of BTA between the initial and final examination and the association between radiographic factors and the reconstruction of the interdental papilla by means of injectable hyaluronic acid gel were evaluated.
RESULTS
All sites showed improvement between treatment examinations. Thirty-six sites had complete interdental papilla reconstruction and 21 sites showed improvement ranging from 19% to 96%. The CP-BC correlated with the IPRR. More specifically, when the CP-BC reached 6 mm, virtually complete interdental papilla reconstruction via injectable hyaluronic acid gel was achieved.
CONCLUSIONS
These results suggest that the CP-BC is closely related to the efficacy of hyaluronic acid gel injection for interdental papilla reconstruction.

Keyword

Dental esthetics; Hyaluronic acid; Interdental papilla

MeSH Terms

Esthetics, Dental
Gingiva*
Humans
Hyaluronic Acid*
Male
Needles
Treatment Outcome
Hyaluronic Acid

Figure

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  Figure 1 The clinical photographic and periapical radiographic standardization device.

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  Figure 2 The measurement of clinical photographs using an image analysis system.

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  Figure 3 The radiographic analysis. Horizontal and vertical wires of 5-mm length are shown. IDR, the interproximal distance between roots; CP-BC, the distance between the most apical part of the CP (contact point) and the most coronal portion of the BC (bone crest).

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  Figure 4 A case of complete interdental papilla reconstruction. (A) At baseline. (B) At 6 months after reconstruction.

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  Figure 5 A case of partial interdental papilla reconstruction. (A) At baseline. (B) At 6 months after reconstruction.

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  Figure 6 The correlations among the distance between the contact point and the bone crest (CP-BC), the interproximal distance between the roots (IDR), and the baseline black triangle. (A) Statistically significant positive correlation between CP-BC and the baseline black triangle was observed. (B) No correlation was observed between the IDR and the baseline black triangle. , Black triangle area (mm2); , Black triangle height (mm); , Black triangle width (mm). r, Pearson correlation coefficient. a)Statistically significant (P<0.05).

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  Figure 7 The correlation between the distance between the contact point and the bone crest (CP-BC) and the interdental papilla reconstruction rate (IPRR). Two groups were categorized based on a CP-BC cut-off value of 6 mm. A statistically significant negative correlation of CP-BC>6.0 mm and IPRR was observed. r, Pearson correlation coefficient. a)Statistically significant (P<0.05).

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