title: The association between radiographic embrasure morphology and interdental papilla reconstruction using injectable hyaluronic acid gel.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the clinical efficacy of enhancing deficient interdental papilla with hyaluronic acid gel injection by assessing the radiographic anatomical factors affecting the reconstruction of the interdental papilla.
  
  
  METHODS
  Fifty-seven treated sites from 13 patients (6 males and 7 females) were included. Patients had papillary deficiency in the upper anterior area. Prior to treatment, photographic and periapical radiographic standardization devices were designed for each patient. A 30-gauge needle was used with an injection-assistance device to inject a hyaluronic acid gel to the involved papilla. This treatment was repeated up to 5 times every 3 weeks. Patients were followed up for 6 months after the initial gel application. Clinical photographic measurements of the black triangle area (BTA), height (BTH), and width (BTW) and periapical radiographic measurements of the contact point and the bone crest (CP-BC) and the interproximal distance between roots (IDR) were undertaken using computer software. The interdental papilla reconstruction rate (IPRR) was calculated to determine the percentage change of BTA between the initial and final examination and the association between radiographic factors and the reconstruction of the interdental papilla by means of injectable hyaluronic acid gel were evaluated.
  
  
  RESULTS
  All sites showed improvement between treatment examinations. Thirty-six sites had complete interdental papilla reconstruction and 21 sites showed improvement ranging from 19% to 96%. The CP-BC correlated with the IPRR. More specifically, when the CP-BC reached 6 mm, virtually complete interdental papilla reconstruction via injectable hyaluronic acid gel was achieved.
  
  
  CONCLUSIONS
  These results suggest that the CP-BC is closely related to the efficacy of hyaluronic acid gel injection for interdental papilla reconstruction.
authors: Department of Periodontology, Chosun University School of Dentistry, Gwangju, Korea .
authors: Won-Pyo
authors: 0000-0003-1911-3454
authors: WP
authors: Lee
authors: Department of Oral and Maxillofacial Radiology, Chosun University School of Dentistry, Gwangju, Korea .
authors: Yo-Seob
authors: 0000-0003-1804-5648
authors: YS
authors: Seo
authors: Department of Prosthodontics, Chosun University School of Dentistry, Gwangju, Korea .
authors: Hee-Jung
authors: 0000-0002-2015-1530
authors: HJ
authors: Kim
authors: Department of Periodontology, Chosun University School of Dentistry, Gwangju, Korea .
authors: Sang-Joun
authors: 0000-0001-8818-549X
authors: SJ
authors: Yu
authors: Department of Periodontology, Chosun University School of Dentistry, Gwangju, Korea .
authors: Byung-Ock
authors: 0000-0001-8952-617X
authors: BO
authors: Kim
keywords: Dental esthetics; Hyaluronic acid; Interdental papilla