Author:
Dong Jia-chen,Liao Yue,Sun Meng-jun,Gong Yin,Chen Hui-wen,Song Zhong-chen
Abstract
Abstract
Background
Gingival papilla defects, which cause an unpleasant appearance and involve the upper anterior teeth, may be triggered by several factors. Several noninvasive and invasive techniques have been proposed for gingival papilla reconstruction. The combination of interproximal tunneling and customized connective tissue grafts (CTGs) has shown promise in papilla augmentation. However, due to the narrowness and limited blood supply of the gingival papilla, the long-term outcomes of these techniques remain unpredictable. Therefore, achieving tension-free coronal advancement of the interdental papilla and proper placement of the CTG is crucial for successful long-term outcomes and could provide widely applicable methods for papilla augmentation.
Case report
In this study, we enrolled three patients with gingival papilla defects in the maxillary anterior teeth. For reconstruction, we proposed a modified interproximal tunneling (MIPT) technique combined with a CTG. A crucial modification based on previous studies involved adding a cutback incision to the base of the palatal vertical incision, resulting in tension-free healing. Additionally, the CTG was sutured upright to further enhance the height of the gingiva papilla. To evaluate the efficacy of the MIPT technique, the clinical parameters—including the Jemt papilla index and the distance from the tip of the papilla to the interproximal contact point—were examined using a periodontal probe (UNC15, Hu-friedy) at baseline and 12 months after surgery. All three patients achieved satisfactory papilla reconstruction 12 months after the surgery. These three cases were used to evaluate the efficacy of the MIPT technique combined with the customized CTG. An average increase in the Jemt papilla score from 1.6 to 2.8 and a reduction in the distance from the papilla tip to the contact point of adjacent teeth from 2 mm to 0.08 mm were observed 12 months after surgery.
Conclusion
The preliminary results confirmed that this technique holds promise for gingival papilla augmentation between tooth/tooth or tooth/implant.
Funder
fundamental research program funding of Ninth People’s Hospital affiliated to Shanghai Jiao Tong university School of Medicine
Publisher
Springer Science and Business Media LLC
Reference22 articles.
1. Rasperini G, Tavelli L, Barootchi S, McGuire MK, Zucchelli G, Pagni G, Stefanini M, Wang HL, Giannobile WV. Interproximal attachment gain: the challenge of periodontal regeneration. J Periodontol. 2021;92(7):931–46.
2. Tarnow DP, Magner AW, Fletcher P. The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla. J Periodontol. 1992;63(12):995–6.
3. Yin XJ, Wei BY, Ke XP, Zhang T, Jiang MY, Luo XY, Sun HQ. Correlation between clinical parameters of crown and gingival morphology of anterior teeth and periodontal biotypes. BMC Oral Health. 2020;20(1):59.
4. Gadi S, Subramanian S, Prakash PSG, Appukuttan D, Thanigaimalai A, Bahammam MA, Alzahrani KJ, Alsharif KF, Halawani IF, Alnfiai MM, et al. Interdental Papillary Reconstruction by microtunnelling technique using Autologous Biomatrices-A Randomised Controlled Clinical Trial. Med (Kaunas). 2022;58(10):1326.
5. Jemt T. Regeneration of gingival papillae after single-implant treatment. Int J Periodontics Restorative Dent. 1997;17(4):326–33.