One of the most difficult and elusive goals for the periodontist in the esthetic aspect of periodontal therapy is the reconstruction of the interdental papilla. Inflammatory enlargements are characterized by swelling or edema, redness, and a tendency to bleed during tissue manipulation figures 149 and 1410. An esthetic surgical procedure sethuraman, shruthi, s. Several reasons contribute to the loss of interdental papillae, and various surgical and nonsurgical techniques for papillary reconstruction have been proposed. Surgical reconstruction of interdental papilla using subepithelial connective tissue graft by microsurgical technique. Reconstruction of the interdental papilla is one of the most challenging and least predictable of treatments. At 6 mm and above, some papilla is still observed even at 9 mm or more on teeth as well as singletooth implants, but with no predictability. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Pdf on nov 30, 2018, shabnam jahan and others published reconstruction of interdental papilla using two surgical. Connective tissue graft by microsurgical technique. The patients were treated for interdental papilla reconstruction with a partial thickness flap. Comparison of two surgical techniques for the reconstruction of interdental papilla. A comparative evaluation of reconstruction of interdental.
Interdental papillae reconstruction inside dental technology. These black triangles appear extremely unaesthetic and are unacceptable. In the third follow up at 6 months 43% of samples showed 50% improvement or higher. In the posterior region, it is broader and was formerly described as having a concave col or bridge shape cohen 1959. Interimplant papilla reconstruction semantic scholar. Compromised esthetics frequently results from deficient interdental papilla and the reconstruction of the lost interdental papilla remains a challenge for the periodontist.
The treatment was planned for reconstruction of lost interdental papilla using prf. Application of hyaluronic acid gel for reconstruction of interdental papilla was successful in a 6month period. A novel tissue engineering technique for regeneration of lost interdental papillary height rutuj surana 1, vaishali ashtaputre 1, satish doiphode 1, kiran kharat 2, purshottam rakhewar 1, maya mhaske 1 1 department of periodontics, c. Interdental papilla article about interdental papilla by. Reconstruction of interdental papilla using hyaluronic acid the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Esthetic considerations for the interdental papilla this pdf is available for free download from a site hosted by medknow publications.
Listing a study does not mean it has been evaluated by the u. Reconstruction of interdental papilla using hyaluronic. Interdental papilla reconstruction combining periodontal. Comparison of surgical reconstruction of interdental. Clinical evaluation of a surgical procedure for the reconstruction of the interdental papillae, as a treatment modality for unesthetic open embrasure in the maxillary anterior region a pilot study. A pouch was created with a semilunar incision, prf was prepared and inserted into the. Interdental papillae are the extensions of gingiva filling the spaces between adjacent teeth. Six month clinical evaluation of interdental papilla. In the last decade, esthetics has become a major concern in periodontal therapy. In the second follow up, 10% of subjects showed improvement in interdental papilla reconstruction by 50%.
In the modern era, missing interdental papilla is a cause of major concern to most of the patients. Hence, it is very vital to maintain the integrity of the papilla during second stage implant surgery. Honestly, i was hoping i never have to come back here after two years worth of headaches with teeth issues and finally having some relief after everything seemed to have calmed down last year in dec. Caranza stated that reconstruction of interdental papilla with an underlying subepithelial connective tissue graft is successful and this technique minimizes surgical trauma and blockage of blood supply to the existing papilla by accessories to papillary area through vertical incision. The loss of interdental papilla poses a challenging situation following excision of sessile growth in the interdental papillae. Simultaneous surgical excision of localized gingival overgrowth and papilla reconstruction with subepithelial connective tissue graft. Denoting the relationship between the proximal surfaces of the teeth of the same arch. Surgical reconstruction of interdental papilla using subepithelial. Interdental papilla reconstruction combining periodontal and orthodontic therapy in adult periodontal patients. The reepithelialization of traumatic injuries can completely restore the papilla 1. Recently, i found out that there seems to be a dark space in between the top middle tooth. Correlation of papilla to crestal bone levels around single. More importantly it plays an important and crucial role in an esthetic component of a natural dentition.
The interdental papilla may be lost or reduced in height, forming black triangles due. The purpose of the study was to describe and evaluate a novel marginal incision technique the papilla base incision, which preserves the integrity of the interdental papilla during and after endodontic surgery in cases where there is no evi. Comparison of surgical reconstruction of interdental papilla. Anatomic variables affecting interdental papilla mahale sa. The role of subepithelial connective tissue graft for. Interdental papilla is seen in the space between two adjacent teeth. It acts as a biological barrier in the protection of periodontium. Longstanding gingival enlargements have a significant fibrotic component as well. Postoperative evaluation was done after a week in a month interval for three months. Ceramic veneers with gingivashaded porcelain to replace lost interdental papillae. A number of techniques have been tried, but the results still lack predictability. Journal of interdisciplinary dentistry comparison of two. Pdf interdental papilla reconstruction in adult orthodontics.
The aim of this study is to evaluate the anatomic variables affecting the interdental papilla. Interimplant papilla reconstruction journal of contemporary dentistry, januaryapril 2014. Minimally invasive treatment for reconstruction of deficit. Several surgical and nonsurgical procedures to rebuild lost papillae have been presented. Reconstruction of interdental papilla can be achieved. Papilla reconstruction procedure fms dental hospital. Interdental papilla augmentation along with reconstruction of interdental bone to create appropriate support for gingival papilla has been reported. Read six month clinical evaluation of interdental papilla reconstruction with injectable hyaluronic acid gel using an image analysis system, journal of esthetic and restorative dentistry on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. The purpose of this article is to present a clinical technique for maintaining papillary height and form following single anterior tooth removal.
Simplified papilla preservation technique free download as powerpoint presentation. Surgical considerations currently there is no predictable surgical procedure to retrieve the interdental papilla 29. Interdental definition of interdental by medical dictionary. Simplified papilla preservation technique dentistry.
Papilla reconstruction procedure is done to eliminate unaesthetic black triangles created by lack of adequate interdental gingiva. Surgical reconstruction of interdental papilla using. Surgical reconstruction of lost interdental papilla. Interdental papilla definition of interdental papilla by. Interdental papilla medical definition merriamwebster. Progress in gingival dadilla u one of the most difficult and elusive goals for the periodontist in the reconstructive, regenerative and aesthetic aspect of periodontal therapy is the reconstruction of the interdental papilla that has been lost from either disease or previous pocket eradication periodontal therapy. Reconstruction of deficit interdental papillae j dent specialities. The interdental papilla, also known as the interdental gingiva, is the part of the gums gingiva that exists coronal to the free gingival margin on the buccal and lingual surfaces of the teeth. Ta thickening seen as an elevation of the gingiva that fills the interproximal space between two adjacent teeth. Since the amount of connective tissue required was minimal the palatal site which is easily accessible for. A clinical study harjeet singh and mandlik vb department of periodontics, naval institute of dental sciences, mumbai, maharashtra, india. In some cases, although white esthetics can be achieved, pink esthetics, or reconstruction of the lost interdental papilla, is a problem, especially when the distance from the base of the contact point to the alveolar bone is greater than 5 mm 8, 9.
This is a temporary file and hence do not link it from a website, instead link the url of this page if you wish to link the pdf file. The borders of dental papilla are superiorly the base of the. Increasing esthetic demands of the modern era has converted modern dentistry to pink and white esthetic dentistry. Gingival hyperplasia usually begins in the interdental papilla and is located in the anterior segment of the mouth. The interdental papillary reconstruction was fairly successful. Instead of placing the semilunar incision over the root surface, this incision is placed in the interdental region. A novel window technique 2 years followup r lambodharan 1, vr balaji 2 1 department of prosthodontics, csi college of dental sciences and research, madurai, tamil nadu, india 2 department of periodontics, csi college of dental sciences and research, madurai, tamil nadu, india.
An evaluation of a periodontal plastic surgical procedure. The interdental papilla is defined as the gingival tissue extending from the incisal tip of the papilla to a line tangential to the gingival margins of the two adjacent teeth. Damodharan deepalakshmi, ramakrishnan swamy ahathya, sunitha raja, aravind kumar surgical reconstruction of lost interdental papilla. Clinical evaluation of papilla reconstruction using. The aim of this study is to evaluate the clinical outcome of using the hyaluronic acid gel in reconstructing interdental papillae at the aesthetic zones in a followup period of six months. The predictable reconstruction of the interdental papilla in the future requires adopting a principle similar to the concept used in the semilunar coronally repositioned flap. The loss of the papilla in your case is a combination of factors including. A novel tissue engineering technique for regeneration of. Papilla anatomy is restored and new crown is placed. However, even with these different surgical techniques with different flap designs, results are elusive, not predictable and longterm stability are lacking. Patient had multiple surgical procedures in an attempt to restore the loss interdental papilla.
From the present investigation, we established that the. Correlation of papilla to crestal bone levels around. This case report demonstrates complete reconstruction of the papilla following a semilunar coronally repositioned papilla technique with 6 months followup. Abstract reconstruction of the interdental papilla that has been lost because of trauma or inflammatory periodontal disease is one. The role of subepithelial connective tissue graft for reconstruction of interdental papilla. One of the most difficult goals in the regeneration of the soft tissues is the reconstruction of interdental papilla. S dental college, aurangabad, india 2 department of biotechnology, deogiri college, aurangabad, india. Papilla score ps, tooth formshape, gingival thickness, crest bone height and keratinized gingivaattached gingiva were recorded for. Sandhu, dds, phd, dip perio abstract migration of maxillary anterior teeth because of the loss of periodontal support can alter the appearance of the esthetic zone. A novel surgical procedure for papilla reconstruction. Interdental papilla reconstruction in adult orthodontics article pdf available in world journal of orthodontics 51. Esthetic considerations for the interdental papilla. A novel incision design for interdental papilla reconstruction.
Moreover, the col is a valleylike depression, which connects the buccal and lingual papilla and takes the form of the interproximal contact. The interdental papillae fill in the area between the teeth apical to their contact areas to prevent food impaction. Takei one of the most difficult and elusive goals for the periodontist in the reconstructive, regenerative and aesthetic aspect of periodontal therapy is the reconstruction of the interdental papilla that has been lost from either disease or previous pocket eradication periodontal therapy. No specific technique is recommended so far in literature to harvest the graft from palatal region for papilla reconstruction. Simultaneous surgical excision of localized gingival.
Pdf surgical reconstruction of the interdental papilla. Comparison of two surgical techniques for the reconstruction of interdental papilla s shruthi 1, sheela kumar gujjari 2, kiran prakash mallya 3 1 department of periodontology, sri siddhartha dental college and hospital, a constituent of sri siddhartha university, agalkote, tumkur, india 2 department of periodontology, jss dental college and hospital, a constituent of jss university, mysore. The paper presented various surgical and nonsurgical approaches to restore the same. Managementofinterdental 1 n 2 periodonticsprevention. A case report is presented here to demonstrate a technique by which a collapsed interdental. Pdf the loss of interdental papillae may create esthetic and phonetic problems and facilitates food impaction.
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