Causes | Insights | Management
Papilla Reconstruction
Interdental papilla is the portion of the gingiva, which occupies the space between two adjacent teeth. It is very important from an aesthetic point of view, because its absence can lead to cosmetic discomfort of the patient, especially if present in the esthetic zone. Other than that, it may result in phonetic difficulty and food impaction. This absence or loss of the interdental papilla in the aesthetic zone results in the formation of so-called Dark Triangle / Black Triangle which poses a great challenge for dental treatment.
Anatomy of Interdental Papilla
Interdental papillae are the extensions of gingiva filling the spaces between neighbouring teeth. It is formed by dense connective tissue covered by oral epithelium and may be influenced by the height of the alveolar bone, the distance between the teeth and interdental contact point. Because the tooth mass bordering the interdental papilla is less in the anterior teeth, the interdental papilla is narrow and has a pyramidal shape with its tip just below the contact point. In posterior teeth, due to the presence of larger tooth mass, it is wider and with a ridge-shaped concave area .
In the anterior teeth, the location of contact points varies. For example, the contact point between two central incisors is located at the incisal third of the labial aspect. The contact point between central and lateral incisor is located in the middle and the contact point between the lateral incisor and canine is located at the cervical third. In other words, we can say that the interdental papilla between two central incisors is filled with more space than the other teeth in the anterior region.
Factors Determining the Presence or Absence of Interdental Papilla
There are multiple factors which determine the presence or absence of interdental papilla. These factors include -
- changes in tooth alignment during orthodontic treatment,
- loss of periodontal ligament resulting in recession,
- loss of alveolar bone height in relation to the interproximal contact,
- angulation of the roots,
- presence of crowns and
- active periodontal inflammatory diseases.
Active periodontal inflammatory diseases are associated with the loss of interdental papilla/papillae. Periodontal pockets with probing depth greater than 3 mm will lead to an increase in plaque retention, inflammation, and recession. As the resorption of alveolar crest progresses, the distance between the contact point and the alveolar bone crest increases, resulting in loss of interdental papilla.
Classification of the interdental papilla loss
Normal
The interdental papilla occupies the entire embrasure space apical to the interdental contact point/area.
Class I
Free for members
Keep reading — it's free
The rest of this article is open to DentalReach members. Create a free account, or sign in, and every article on the site opens in full.
