Clinical evaluation of periodontal plastic surgery method in interdental papilla reconstruction

Interdental papilla loss is a clinical condition that occurs due to various reasons, which can lead to functional problems and creates especially aesthetic complaints for patients. Different techniques have been used in periodontology to treat interdental papillae loss, but the successful and predictable treatment has not been identified so far. The aim of this study is to evaluate the effectiveness of papillae reconstruction due to a periodontal plastic surgery technique together with the use of subepithelial connective tissue graft or concentrated growth factor in individuals with maxillary anterior interdental papilla loss. Fifty eight interdental papillae area in twelve patients included in this study who applied to Gazi University Faculty of Dentistry Department of Periodontology. Those patients had papilla loss in the maxillary anterior teeth especially with aesthetic and functional complaints. The patients were randomly allocated to the groups in terms of the graft material which would be used. The patients who subepithelial connective tissue graft were applied as Group 1, and the patients concentrated growth factor as Group 2. After phase 1 periodontal therapy, Plaque index (PI), gingival index (GI), pocket depth (CD) and papillary bleeding index (PBI), papilla presence index (PPI) were evaluated at baseline and posttreatment periods of 1, 3 and 6 months in both groups. The distance from the contact point of the teeth to the tip of the papillae, the distance from the gingival edge of the teeth to the tip of the papillae , the horizontal distance of the papilla at the level of the gingival edge, the papilla thickness, the distance from the tip of the papillae to the mucogingival junction (keratinized gingiva), the distance from the contact point to the alveolar crest measurements were recorded. Postoperatively, papillae presence index; black triangle area; distance between the contact point and the tip of the papillae; distance between the gingival margin and the tip of the papillae and the papillary thickness data shown statistically significant improvements in terms of healing. Results regarding the gingival margin to the tip of the papillae distance and the papillae thickness parameters were found pleasing surgical outcome in the CTG group. In this study it can be concluded that CTG application achieved the best esthetic, functional and more stable results for the papillae reconstruction. However, the CGF has also showed similar improvements for the treatment of missing interdental papillae. It was shown that within the specific indications and limitations both CTG and CGF materials can be successfully used for the treatment of interdental papillae loss procedure.