A class 1 papilla fills less than half the interproximal region. There are very fewer surgical techniques to create interdental papilla, which has been very technique sensitive and less predictive in treatment outcome. The loss of papilla can cause cosmetic deformities black triangles, phonetic problems, and food debris accumulation. The purpose of this article is to present a clinical technique for maintaining papillary height and form following single anterior tooth removal. Surgical reconstruction of the interdental papilla. It lies below a cellular aggregation known as the enamel organ. Interdental papilla loss is strongly associated with increasing age, periodontal diseases and post orthodontic treatment. Interdental papilla synonyms, interdental papilla antonyms. Correlation of papilla to crestal bone levels around. Notice the dark spaces between her teeth where the gums are noticeably missing.
Papilla means a small, nipplelike projection, and papillae is the plural form of the word. On the facial aspect, the free gingival margin averages. The interdental papillae fill in the area between the teeth apical to their contact areas to prevent food impaction. The purpose of the present study was to determine if there was a difference in the perception of aesthetics, by dental specialty. International endodontic journal, 35, 453460, 2002. The interdental papilla, interdental gingiva, is the part of the gingiva that exists coronal to the free gingival margin on the buccal and lingual surfaces of the teeth. Dermal papillae, at the base of every hair follicle. The tip of the pyramidshaped interdental papilla is positioned immediately below the proximal contacts, and the gingival col, a vshaped depression connecting the buccal and lingual interdental papillae, is adapted to the shape. Graphing the papilla to fill the gap is an incredibly difficult procedure that very few doctors can do. Although theyre small, they help to protect the roots of your teeth from exposure, bacteria and the effect of food between your teeth. Surgical techniques are diverse, but none have given predictable results. Interdisciplinary approach to reconstruct papilla in esthetic.
An esthetic surgical procedure sethuraman, shruthi, s. Interdental recession or loss of the interdental papilla is one of the greatest challenges facing the dental team. Loss of interdental papilla marks phonetics, functional and esthetic problem. The aim of this study is to evaluate the anatomic variables affecting the interdental papilla. Management of interdentalinterimplant papilla deep blue. Comparison of surgical reconstruction of interdental. In such a scenario connective tissue graft ctg is considered the gold standard for. The concept of the interdental papillary house has been established not. Several reasons also lead to absence of interdental papillae including.
Distinctive molecular composition of human gingival. The interdental papillae are first repositioned to their correct anatomical location. Absence of interdental papilla raises concern over phonetic. At implant crown delivery, evaluating both mesial and distal interdental regions, the average class papilla was type 2. Jun 15, 2019 the interdental papilla is the gingival portion that occupies the proximal area underneath the contact between two adjacent teeth. Methodology twenty healthy patients referred for surgical treatment of persisting apical periodontitis, who were free of periodontal disease and had intact interdental papillae were included in the study. Often the loss of papilla is a consequence of periodontal disease because of gingival inflammation, attachment loss and interproximal bone height resorption. Dont discount the health of the tiny bit of gum tissue between your teeth. Aim the purpose of the present study was to describe and evaluate a new incision technique. However, the interdental papilla has limited regeneration potential compared to other parts of the gingiva.
Velvart clinic for periodontology, endodontology and cariology, university of basel, switzerland abstract velvart p. Reconstruction of interdental papilla using hyaluronic acid. Amphibian papilla and basal papilla, parts of the inner ear of frogs. The dental papilla gives rise to the dentin and pulp of a tooth. Increasing esthetic demands in dentistry have created a need to restore all parts of the gingiva.
Synonyms for interdental papilla in free thesaurus. Surgical techniques are manifold, but are challenging and very unpredictable. The location and function of the interdental papilla. The dental papilla appears after 810 weeks intra uteral life. To achieve reconstruction of the lost interdental papilla is difficult and challenging, as it is associated with the patient smile and esthetics.
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. Therefore, the future of papilla reconstruction cannot use free grafting or the conventional pedicle displacement of gingiva. Interdental papilla an overview sciencedirect topics. In 1985, shapiro studied the possibility of regeneration of interdental papillae using periodic curettage. Papilla fish anatomy, small lumps of dermal tissue found in the mouth which hold taste buds. He stated that repeated scaling, root planning, and curettage of the papillary tissue every 15 days for 3 months may induce a proliferative hyperplastic inflammatory reaction of the papilla and may be used to reconstruct papillae destroyed by acute necrotizing ulcerative gingivitis. The free gingival margin averaged 23 mm above underlying facial bone, whereas the tip of the papillae is about 4. Progress in gingival papilla reconstruction thomas han, dds. The structure of the interdental papilla is dense connective tissue covered by oral epithelium.
Dental papilla, cells involved in a developing tooth. Interdental papilla length and the perception of aesthetics. Reconstruction of interdental papilla using hyaluronic. The influence of the distance from the contact point to. Factors influencing the length of the interproximal dental papilla. Esthetic considerations for the interdental papilla. Correlation of papilla to crestal bone levels around single.
From the present investigation, we established that the. Nordland and sandhu published their landmark paper showing not only the successful technique but also more than 10 years of post operative longevity. Pdf surgical reconstruction of the interdental papilla. Loss of interdental papilla predisposes to phonetic, functional, and esthetic problem. Standardized photographs were presented to sixtyfive randomly selected dentists from new york university college. Papilla reconstruction for many years it was thought that once the interdental papilla was lost it was impossible to replace it. Treatment planning and its sequencing frequently require not only restorative and periodontal care, but also orthodontic therapy. Towards this goal, we used computer assisted asymmetric alteration of the papilla length below the contact point of the clinical crowns in the aesthetic zone figures figures1, 1,2, 2,3, 3, and and4 4.
Interdisciplinary approach to reconstruct papilla in. The decision was made to treat the defect with free rotated papilla autograft combined with enveloping technique. Pdf anatomic variables affecting interdental papilla researchgate. Interdental papilla article about interdental papilla by. When the papilla are unhealthy, they might be tender, have a bulbous. A novel incision design for interdental papilla reconstruction. Pdf surgical and nonsurgical techniques have been proposed to. Progress in gingival papilla reconstruction thomas han dds. Interdental papilla definition of interdental papilla by. Using manual pressure, the provisional restoration was seated. The purpose of the study was to determine if there was a difference in the perception of aesthetics, by dental specialty, using computer assisted asymmetric alteration of the papilla length in the aesthetic zone with an apical alteration of the contact point of the clinical crowns. In this case, they are structures of the gums that project between the teeth.
The preoperative papilla height was recorded by measuring the distance. Crest bone height, gingival thickness, interdental papilla, tooth formshape. Papilla interdentalis definition of papilla interdentalis. The present case series demonstrates an interdisciplinary approach with a combination of modified beagles technique and composite restoration to reconstruct interdental papilla between maxillary central incisors with 6 months follow up. Assessment of hyaluronic acid gel injection in the. Interdental papilla medical definition merriamwebster. Major duodenal papilla, the opening of the pancreatic duct and common bile.
Teeth with a free gingival margin located more apical than ideal and a flat gingival scallop may present a compromised situation after tooth extraction. The loss of the dental papilla can be a real health concern because every time you eat food lodges in the area. The loss of the interdental papilla because of the interproximal bone loss. A class 0 papilla was a complete lack of papilla height box 217. Shape the shape of the gingiva varies considerably depending on the shape of the teeth, their alignment in the arch, the location and size of the area of the proximal contact, the dimensions of the facial and lingual gingival embrasures, and the degree of gingival health blunted gingiva interdental papillae do not fill the entire interdental space and have a more flattened, not. Black traingle between teeth dental papilla treatment. Thorough treatment planning is essential for maintenance of the height of the interproximal papillae following tooth removal. This type of recession defect is due to the loss of the interproximal periodontal attachment apparatus. In natural teeth, the height of the interdental papilla was influenced by the location of the contact point of the tooth and the level of the proximal bone crest tarnow et al. In embryology and prenatal development, the dental papilla is a condensation of ectomesenchymal cells called odontoblasts, seen in histologic sections of a developing tooth. The interdental papilla is the gingival portion that occupies the proximal area underneath the contact between two adjacent teeth. For singletooth implants, a similar finding was observed. It has distinctive anatomical, histological and molecular characteristics with tremendous significant importance from an esthetic perspective, especially in the anterior region since it is almost universally. Root coverage with free rotated papilla autograft using.