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Non-Surgical Cosmetic Treatment Modalities for Interdental Papilla Reconstruction "Black Triangles": An
Ayah Elhaj1, Bashar Shatta1, Sheila Nguyen1
1Academic Plastic Surgery, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
Journal of Cosmetic Dermatology
|May 14, 2026
Summary
Non-surgical treatments like hyaluronic acid injections effectively correct "black triangles" caused by interdental papilla loss, offering high patient satisfaction. While evidence for other methods is limited, these options provide a promising alternative to surgery with minimal adverse events.
Area of Science:
- Dental aesthetics and reconstructive dentistry.
- Periodontology and cosmetic dentistry.
Background:
- Interdental papilla loss results in unesthetic "black triangles", impacting dental and facial aesthetics.
- Non-surgical interventions are emerging as alternatives to complex surgical reconstructions.
Purpose of the Study:
- To evaluate the effectiveness, patient satisfaction, and safety of non-surgical cosmetic treatments for correcting "black triangles".
Main Methods:
- A comprehensive literature search was performed across major databases (PubMed, Cochrane, Scopus, Embase) from January 2013 to January 2024.
- Included case series, cohort studies, and randomized controlled trials, assessed using BestBETs methodology and the "Quality Assessment Tool for Quantitative Studies".
Main Results:
- Nineteen human studies (6 level II, 13 level III/IV evidence) were included.
- Hyaluronic acid injections demonstrated effectiveness and safety for "black triangle" correction and smile improvement (Level II evidence).
- Evidence for autologous platelet concentrates, photobiomodulation, and microneedling with vitamin C is limited, though generally recommended for efficacy and patient satisfaction.
Conclusions:
- Non-surgical treatments present a promising, lower-complication alternative for interdental papilla reconstruction with favorable aesthetics.
- Current evidence is limited, necessitating cautious interpretation and further high-quality clinical trials for long-term outcomes.
