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Interdental papilla reconstruction: a systematic review.
Monal Patel1, Alaa Guni1, Luigi Nibali2
1Periodontology Unit, Centre for Host Microbiome Interactions, King's College London, Floor 18, Tower Wing, Great Maze Pond, London, SE1 9RT, England, UK.
Clinical Oral Investigations
|January 17, 2024
Summary
Interdental papilla reconstruction options like hyaluronic acid, platelet-rich fibrin (PRF), and grafting show promise for improving "black triangles." Surgical grafting offers the most robust evidence for long-term results.
Area of Science:
- Periodontology and Regenerative Dentistry
- Aesthetic Dentistry
Background:
- Interdental papilla loss, often presenting as "black triangles," is a common aesthetic concern for patients.
- Current management options for reconstructing lost interdental papilla lack clear evidence-based recommendations.
Approach:
- A systematic review was conducted, including 45 studies (7 RCTs, 2 cohort studies, 19 case series, 17 case reports).
- Studies investigated various treatments: hyaluronic acid, platelet-rich fibrin (PRF), soft tissue grafting, and orthodontics.
- Outcome measures focused on black triangle dimensions and papillary fill percentage.
Key Points:
- Hyaluronic acid injections, PRF, surgical grafting, and orthodontics demonstrate potential for interdental papilla reconstruction at 3 months.
- Sub-epithelial connective tissue grafting shows the strongest evidence for long-term reduction of "black triangles."
- High heterogeneity among studies precluded meta-analysis.
Conclusions:
- Various reconstructive modalities show promise, but robust evidence is limited.
- Sub-epithelial connective tissue grafting appears most effective for long-term "black triangle" reduction.
- Further high-quality RCTs with extended follow-up and patient-reported outcomes are necessary.
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