Closing Spaces, Opening Smiles: Interdental Papilla Reconstruction with Hyaluronic Acid

Loss of interdental papillae leads to the formation of black triangles between the teeth. Management includes several surgical and non-surgical techniques. Recent technique includes the use of 0.2% hyaluronic acid gel. It’s a non-invasive, non-toxic procedure. Hyaluronic acid (HA) stimulates cell proliferation, migration, angiogenesis, reepithelization and proliferation of basal keratinocytes. To evaluate the efficacy of clinical application of Injectable HA gel for the reconstruction of interdental papilla and eliminate black triangles in the esthetic zone. The study included 15 patients with Interdental papilla loss or defects presenting to the Department of Periodontics who met inclusion criteria. Under local anesthesia, 0.2-0.3 ml of 0.2% HA gel (GENGIGEL®) was loaded into an insulin syringe and injected at three sites per papilla (buccally 2-3 mm apical to the tip of the papilla, at the interdental tip, and palatal/lingually between the two previously injected sites). Parameters including black triangle width, height, interproximal width, contact point to gingival margin distance were measured at day-0, 7th day, 21st day respectively. The study revealed significant improvement in the parameters like black triangle width, height, interproximal width, contact point to gingival margin distance at 7th day and 21st day compared to baseline after application of HA gel in the interdental papilla. The study shows that 0.2% Hyaluronic acid Gel (GENGIGEL®) improves interdental papilla size and gingival contour short- term, making it an effective and minimally invasive treatment for interdental papilla loss in the aesthetic zone. Key Words: Interdental papilla (IDP), Hyaluronic acid (HA), Black triangle width, Black triangle height, interproximal width.