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VOLUME 10 , ISSUE 2 ( July-December, 2018 ) > List of Articles

Original Article

Treatment of Interdental Papillary Deficiency Using Different Concentrations of Hyaluronic Acid: A Pilot Study

Kharidhi Laxman Vandana, Juturu Thimmasetty

Keywords : Esthetics, Hyaluronic acid, Interdental papilla, Interdental papillary deficiency

Citation Information : Vandana KL, Thimmasetty J. Treatment of Interdental Papillary Deficiency Using Different Concentrations of Hyaluronic Acid: A Pilot Study. CODS J Dent 2018; 10 (2):25-28.

DOI: 10.5005/jp-journals-10063-0039

License: CC BY-NC 4.0

Published Online: 01-04-2020

Copyright Statement:  Copyright © 2018; The Author(s).


Background: In the present era, demand of beauty and esthetics has increased rapidly. Interdental papilla (IDP) construction, especially in the esthetic area, is one of the most challenging tasks. Interdental papilla loss might occur due to several reasons as a consequence of periodontal surgery or trauma. Aims and objectives: The present study aimed to prepare economically feasible injectable form of hyaluronic acid gel (HA) in three different concentrations—HA 1%, 2%, and 5% to evaluate its efficacy in the augmentation of IDP. Materials and methods: Total 14 sites were selected with 6 sites (1% HA), 3 sites (2% HA), and 5 sites (5% HA), respectively, for the IDP reconstruction in 18–40 years of age group of both the sexes. Hyaluronic acid was injected at 2 mm apical to tip of papilla for continuous 3 weeks. The IDP augmentation was measured at a time interval of 1, 3, and 6 months using stent with UNC15 probe and photographic analysis was done using Image J software. Results and conclusion: From the results of this case series, 5% HA has shown both clinical and photographic improvements, which can be dependable for papillary enhancement.

  1. Singh VP, Uppoor AS, Nayak DG, et al. Black triangle dilemma and its management in esthetic dentistry. Dent Res J (Isfahan) 2013;10(3):296–301.
  2. Cunliffe J, Pretty I. Patients’ ranking of interdental “black triangles” against other common aesthetic problems. Eur J Prosthodont Restor Dent 2009;17(4):177–181.
  3. Mahale SA, Jagdhane VN. Anatomiv variables affecting interdental papilla. J Int Clin Res Organ 2013;5(1):14–18. DOI: 10.4103/2231-0754.134131.
  4. Pradeep AR, Karthikeyan BV. Periimplant papilla reconstruction: realities and limitations. J Periodontol 2006;77(3):534–544. DOI: 10.1902/jop.2006.050068.
  5. Prato GP, Rotundo R, Cortellini P, et al. Interdental papilla management: a review and classification of the therapeutic approaches. Int J Periodontics Restorative Dent 2004;24(3):246–255. DOI: 10.1016/j.prosdent.2004.07.002.
  6. Kontis TC. Contemporary review of injectable facial fillers. JAMA Facial Plast Surg 2013;15(1):58–64. DOI: 10.1001/jamafacial.2013.337.
  7. Becker W, Gabitov I, Stepanov M, et al. Minimally invasive treatment for papillae deficiencies in the esthetic zone: a pilot study. Clin Implant Dent Relat Res 2010;12(1):1–8. DOI: 10.1111/j.1708-8208.2009.00247.x.
  8. Mansouri SS, Ghasemi M, Salmani Z, et al. Clinical application of hyaluronic acid gel for reconstruction of interdental papilla at the esthetic zone. J Islamic Dent Assoc Iran 2013;25:152–157.
  9. Awartani FA, Tatakis DN. Interdental papilla loss: treatment by hyaluronic acid gel injection: a case series. Clin Oral Investig 2016;20(7):1775–1780. DOI: 10.1007/s00784-015-1677-z.
  10. Lee WP, Kim HJ, Yu SJ, et al. Six month clinical evaluation of interdental papilla reconstruction with injectable hyaluronic acid gel using an image analysis system. J Esthet Restor Dent 2016;28(4):221–230. DOI: 10.1111/jerd.12216.
  11. Bertl K, Gotfredsen K, Jensen SS, et al. Can hyaluronan injections augment deficient papillae at implantsupported crowns in the anterior maxilla? A randomized controlled clinical trial with 6 months followup. Clin Oral Implants Res 2017;28(9):1054–1061. DOI: 10.1111/clr.12917.
  12. 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;24(5):488–492. DOI: 10.11607/prd.00.0596.
  13. O'Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol 1972;43(1):38. DOI: 10.1902/jop.1972.43.1.38.
  14. Srinivas M, Chethana KC, Padma R, et al. A study to assess and compare the peripheral blood neutrophil chemotaxis in smokers and non smokers with healthy periodontium, gingivitis, and chronic periodontitis. J Indian Soc Periodontol 2012;16(1):54–58. DOI: 10.4103/0972-124X.94605.
  15. Wang CT, Lin J, Chang CJ, et al. Therapeutic effects of hyaluronic acid on osteoarthritis of the knee. A meta-analysis of randomized controlled trials. J Bone Joint Surg Am 2004;86(3):538–545. DOI: 10.2106/00004623-200403000-00012.
  16. Necas J, Bartosikova L, Brauner P, et al. Hyaluronic acid (hyaluronan): a review. Vet Med 2008;53(8):397–411. DOI: 10.17221/1930-VETMED.
  17. Tal H. Relationship between the interproximal distance of roots and the prevalence of intrabony pockets. J Periodontol 1984;55(10): 604–607. DOI: 10.1902/jop.1984.55.10.604.
  18. 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;63(12):995–996. DOI: 10.1902/jop.1992.63.12.995.
  19. Cho HS, Jang HS, Kim DK, et al. The effects of interproximal distance between roots on the existence of interdental papillae according to the distance from the contact point to the alveolar crest. J Periodontol 2006;77(10):1651–1657. DOI: 10.1902/jop.2006.060023.
  20. Kois JC. Predictable single tooth peri-implant esthetics: five diagnostic keys. Compend Contin Educ Dent 2001;22:199–206.
  21. Ahmad I. Anterior dental aesthetics: gingival perspective. Br Dent J 2005;199(4):195–202. DOI: 10.1038/sj.bdj.4812611.
  22. Burke S, Burch J, Tetz J. Incidence and size of pretreatment overlap and posttreatment gingival embrasure space between maxillary central incisors. Am J Orthod Dentofacial Orthop 1994;105(5):506–511. DOI: 10.1016/S0889-5406(94)70013-3.
  23. Vandana KL, Savitha B. Thickness of gingiva in association with age, gender and dental arch location. J Clin Periodontol 2005;32(7): 820–830. DOI: 10.1111/j.1600-051X.2005.00757.x.
  24. Van der Velden U. Effect of age on the periodontium. J Clin Periodontol 1984;11(5):281–294. DOI: 10.1111/j.1600-051X.1984.tb01325.x.
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