Original Article
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Comparison of two surgical techniques for the reconstruction of interdental papilla S. Shruthi, Sheela Kumar Gujjari1, Kiran Prakash Mallya2 Department of Periodontology, Sri Siddhartha Dental College and Hospital, A Constituent of Sri Siddhartha University, Agalkote, Tumkur, 1Department of Periodontology, JSS Dental College and Hospital, A Constituent of JSS University, Mysore, 2Oral and Maxillofacial surgeon, Vasan Dental Care, Bengaluru, Karnataka, India
Address for correspondence: Dr. S. Shruthi, E‑mail:
[email protected]
ABSTRACT Aim: The aim of the study was to check the effectiveness of both Robert Azzi and Han and Takei technique in reconstructing the lost interdental papilla between maxillary central incisors. It also compared the two techniques. Materials and Methods: Fourteen systemically healthy patients fulfilling the inclusion and exclusion criteria were selected for the study. The clinical parameters were evaluated at baseline, 6 months and 12 months postsurgically. Results: The results showed that there was a statistical significant improvement in both papilla presence index score and papillary height in both the groups from baseline but on comparison, no technique was superior to the other. Conclusion: Both the techniques were equally good in reconstructing the interdental papilla. And no technique was superior to the other.
CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY An open gingival embrasure or black triangle occurs as a result of a deficiency of papilla beneath the contact point. The treatment of open embrasures may require restorative, orthodontic and periodontal considerations depending on the underlying etiology. Treatment of open embrasures requires an interdisciplinary approach of orthodontic, periodontic, and restorative treatment. Open gingival embrasures have complex esthetic and functional problems. An interdisciplinary team approach with the general dentist, orthodontist, and periodontist is critical. Key words: Han and Takei technique, interdental papilla, papilla presence index, papillary height, Robert Azzi technique
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INTRODUCTION
n addition to maintaining dental and periodontal health, dental esthetics has become a great concern for both dental practitioners and patients. In the last decade, esthetics has become a major concern in periodontal therapy with gingival recession resulting in denuded root surface and loss of gingival papilla being the two main concerns in periodontal esthetics. The contour of the interdental tissues, the color and texture of keratinized tissues play a role in esthetics and the presence of interproximal papilla between Access this article online Quick Response Code: Website: www.jidonline.com
DOI: 10.4103/2229-5194.162739
the maxillary anterior teeth being the key esthetic component. Hence, one of the major esthetic challenges in periodontal plastic surgery is the ability of rebuilding the lost papilla in the maxillary anterior segment. Today’s dentist face esthetic standards that require a soft tissue contour with an intact papilla and a symmetrical gingival outline, especially in the interdental area of the maxillary central incisors. The loss of interdental papilla can result in what is known as black triangle which can result in various problems such as food impaction, affect esthetics and phonetics. This is an open access article distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as the author is credited and the new creations are licensed under the identical terms. For reprints contact:
[email protected] How to cite this article: Shruthi S, Gujjari SK, Mallya KP. Comparison of two surgical techniques for the reconstruction of interdental papilla. J Interdiscip Dentistry 2015;5:17-22.
© 2015 Journal of Interdisciplinary Dentistry | Published by Wolters Kluwer - Medknow
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Shruthi, et al.: Surgical reconstruction of interdental papilla
Loss of interdental papilla solely because of soft tissue damage can be restored completely by reconstructive techniques; but reconstruction is generally incomplete if the loss is due to severe periodontal disease and interdental bone resorption. The various interdental papilla reconstruction options that have been available for the dentists have been orthodontic, prosthodontic, and restorative dentistry.[1] Nonsurgical treatment such as repeated curettage[2] and surgical therapies[1,3‑5] have also been advocated. Surgical intervention can be an option if bone crest to contact point distance is
