Interdental papilla reconstruction using injectable hyaluronic acid (HYADENT BG) – a six month prospective clinical study

Abstract

Background: Aims – interdental papilla loss has been a major problem faced daily by periodontists and restorative dentists, as the demand of achieving better esthetics and better function of teeth and periodontium has recently increased. Aim/Hypothesis: This study aims to assess the efficacy of hyaluronic acid to be an effective treatment for interdental papilla loss in the esthetic zone and study the factors associated with reconstruction. Material and Methods: Thirty‐eight patients were referred for treatment to the Periodontology post graduate clinics of Jordan University of Science and Technology for treatment of Inter‐dental papilla loss (IDP). At the beginning 27 subjects (17 females and 10 males) from those referred, were included. A total of 21 patients included in the analyses (14 females and 7 males), of which 86 interdental sites (58 sites in the upper jaw and 28 sites in the lower jaw) treated and followed up. 0.2 mL of HYADENT BG was injected in each receded IDP site and injections were repeated after 21 days, follow up was at 3 and 6 months. Open gingival embrasure was assessed using vertical height of black triangle (BT) and pocket depth (PD). They were recorded at day 1, 3 weeks, 3 and 6 months post therapy using photographs and UNC probe. Patient satisfaction and pain were assessed, and any side effects experienced by the patients were recorded too. Results: All sites showed significant reductions in BT at 3 and 6 months when compared to baseline values (_I_P_i_ < 0.001). sites treated among females showed an additional reduction in BT of 0.85 ± 0.03 mm, significantly greater than in males. Differences in mean BT reduction between upper and lower jaws were not significant. At 3 months, difference in CAL gain between Group A and C was 0.50 ± 0.45, which was statistically significant and between Group B and C was 0.35 ± 0.11, which was not found to be statistically significant (_I_P_i_ = 0.20). Differences in relative CAL between Group A and Group B were also not found to be statistically significant (_I_P_i_ = 0.53). The change was noticed more in the females 0.8 (mm) at 3 months and 0.6 (mm) at 6 months period compared to baseline (_I_P_i_ < 0.05), and in the upper jaw 0.9 (mm) at 3 months and 0.7 (mm) at 6 months period compared to baseline (_I_P_i_ < 0.05). A reduction in PD was noticed but there was no statistical difference between the various recall intervals. The final results were satisfying for the patients especially females (46.9% vs. 34.4% for males (_I_P_i_ > 0.05). Minimal pain was noticed, however 2 patients have reported localized blueish swelling at some sites of injections, nevertheless no systemic side effects were reported by any of the patients. Conclusions and Clinical Implications: In aesthetically relevant areas the use of the HA is recommended. It can be successfully used for construction of missing papilla in women with maxillary papillary loss. [ABSTRACT FROM AUTHOR]