Alka Kaushik1, Pal Pk2, Kshitij Jhamb3, Deepak Chopra4, Vishwajit Rampratap Chaurasia5, Vinaykumar S Masamatti5, Suresh Dk6, Prashant Babaji7. 1. Reader, Department of Periodontics, Yamuna Institute of Dental Sciences & Research , Ghadoli, Yamuna Nagar, Haryana, India . 2. Professor, Department of Prosthodontics, Institute of Dental Sciences , Bhubaneswar, Odissa, India . 3. Senior Lecturer, Department of Oral & Maxillofacial Surgery, Yamuna Institute of Dental Sciences & Research , Ghadoli, Yamuna Nagar, Haryana, India . 4. Professor, Department of Periodontics, Institute of Dental Studies & Technologies , Kadrabad, Modinagar, UP, India . 5. Post Graduate, Department of Conservartive Dentistry & Endodontics, KLE Dental College , Belguam, Karnataka, India . 6. Professor, Department of Periodontics, Maharshi Markendeshwar College of Dental Sciences & Research , Mullana, Ambala, Haryana, India . 7. Professor, Department of Pedodontics, Sharavathi Dental College & Hospital , Shimoga, Karnataka, India .
Abstract
OBJECTIVE: The aesthetics of the patient can be improved by surgical reconstruction of interdental papilla by using an advanced papillary flap interposed with subepithelial connective tissue graft. MATERIALS AND METHODS: A total of fifteen sites from ten patients having black triangles/papilla recession in the maxillary anterior region were selected and subjected to presurgical evaluation. The sites were treated with interposed subepithelial connective tissue graft placed under a coronally advance flap. The integrity of the papilla was maintained by moving the whole of gingivopapillary unit coronally. The various parameters were analysed at different intervals. RESULTS: There was a mean decrease in the papilla presence index score and distance from contact point to gingival margin, but it was statistically not significant. Also, there is increase in the width of the keratinized gingiva which was statistically highly significant. CONCLUSION: Advanced papillary flap with interposed sub-epithelial connective tissue graft can offer predictable results for the reconstruction of interdental papilla. If papilla loss occurs solely due to soft-tissue damage, reconstructive techniques can completely restore it; but if due to periodontal disease involving bone loss, reconstruction is generally incomplete and multiple surgical procedures may be required.
OBJECTIVE: The aesthetics of the patient can be improved by surgical reconstruction of interdental papilla by using an advanced papillary flap interposed with subepithelial connective tissue graft. MATERIALS AND METHODS: A total of fifteen sites from ten patients having black triangles/papilla recession in the maxillary anterior region were selected and subjected to presurgical evaluation. The sites were treated with interposed subepithelial connective tissue graft placed under a coronally advance flap. The integrity of the papilla was maintained by moving the whole of gingivopapillary unit coronally. The various parameters were analysed at different intervals. RESULTS: There was a mean decrease in the papilla presence index score and distance from contact point to gingival margin, but it was statistically not significant. Also, there is increase in the width of the keratinized gingiva which was statistically highly significant. CONCLUSION: Advanced papillary flap with interposed sub-epithelial connective tissue graft can offer predictable results for the reconstruction of interdental papilla. If papilla loss occurs solely due to soft-tissue damage, reconstructive techniques can completely restore it; but if due to periodontal disease involving bone loss, reconstruction is generally incomplete and multiple surgical procedures may be required.
Entities:
Keywords:
Aesthetic; Black triangle; Interdental papilla; Subepithelial connective tissue graft
Authors: Henry Greenwell; Joseph Fiorellini; William Giannobile; Steven Offenbacher; Leslie Salkin; Cheryl Townsend; Phillip Sheridan; Robert Genco Journal: J Periodontol Date: 2005-09 Impact factor: 6.993