Rebuilding the Pink Esthetics: Credible Approaches in Interdental Papillary Reconstruction

Abstract

Introduction: One of the most perplexing aesthetic problems of the periodontium is the formation of black triangles due to the loss of interdental papilla. The complex anatomy of the interdental papillae allows for periodontal disease to progress rapidly, and is the most common cause for the development of ‘black triangles’. Not only are esthetics and phonetics compromised, but interdental papillary deficiency increases the tendency for retention of food debris, thereby hampering oral hygiene maintenance leading to periodontal disease. Due to its sparse vascular supply, interdental papillary reconstruction or augmentation remains as a mystifying periodontal plastic procedure. Objective: To evaluate black triangle fill using nonsurgical and surgical techniques for interdental papilla reconstruction. Methodology: In this case report, non-surgical papillary reconstruction was carried out using two separate agents- injectable platelet-rich fibrin (iPRF) and hyaluronic acid (HA) while the surgical technique employed leucocyte PRF (L-PRF) combined with an advanced papillary flap in patients with loss of interdental papilla in the maxillary anterior region. Conclusion: Optimal black triangle fill was noted postoperatively in both surgical and nonsurgical techniques with interdental papilla reconstruction; however, better patient compliance and less morbidity was observed in the non-surgical approach. In the non-surgical approach, iPRF, resulted in a better fill of the black triangle as compared to hyaluronic acid gel.