title: Interdental papilla loss: treatment by hyaluronic acid gel injection: a case series.
abstract: OBJECTIVE
  The purpose of this prospective clinical trial was to examine the clinical and patient outcomes following esthetic reconstruction of interdental papilla loss in anterior teeth, using an injectable, non-animal-based, hyaluronic acid gel.
  
  
  METHODS
  Ten systemically healthy adults, with at least one anterior site with class I or II interdental papilla loss, were recruited. Following local anesthesia, ∼0.2 ml of hyaluronic acid gel was injected directly into the base of the papilla. The injection was repeated twice 21 days later. Patients were seen monthly for follow-up. Lost papilla surface area was calculated from digital clinical photographs taken at baseline and at 4 and 6 months postoperatively. Differences in lost papilla surface area between baseline and postoperative time points were statistically analyzed. Participants completed questionnaires (satisfaction surveys).
  
  
  RESULTS
  Seventeen sites (13 maxillary, 4 mandibular) were treated in 9 females who completed the study. The lost inderdental papilla area at baseline and at the 4- and 6-month postoperative visits was 1.2 ± 1.8 mm(2) (mean ± SD), 0.6 ± 0.9 mm(2), and 0.7 ± 0.7 mm(2), respectively. Differences between baseline and postoperative visits were statistically significant (p < 0.0001). Two thirds of the patients would choose to undergo the procedure again.
  
  
  CONCLUSIONS
  Use of hyaluronic acid gel to treat interdental papilla loss resulted in significant improvement at 6 months. Patients expressed satisfaction with the obtained improvement and dissatisfaction with the associated procedure discomfort.
  
  
  CONCLUSIONS
  Treatment of interdental papilla loss (black triangle) by hyaluronic acid gel injection appears a promising modality to address this esthetic patient concern.
authors.affiliation: Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Darraiyah Campus, P.O. Box 52500, Riyadh, 11563, Saudi Arabia. fawartani@live.com.
authors.forename: Fatin A
authors.initials: FA
authors.lastname: Awartani
authors.affiliation: Division of Periodontolgy, College of Dentistry, The Ohio State University, Columbus, OH, USA.
authors.forename: Dimitris N
authors.initials: DN
authors.lastname: Tatakis
mesh_terms: D000328:Adult; D003771:Dental Papilla / Q000187:drug effects* / Q000473:pathology*; D004955:Esthetics, Dental; D005260:Female; D005782:Gels; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007267:Injections; D008875:Middle Aged; D023861:Photography, Dental; D011446:Prospective Studies; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage*
chemical_list: D005782:Gels; D055675:Viscosupplements; D006820:Hyaluronic Acid
keywords: Esthetics, Dental; Gingiva; Hyaluronic acid; Incisor; Injections; Surgical procedures, minimally invasive