Therapeutic Options to Restore the Interproximal Papilla

Abstract

Due to a constant increase in the desire of a nice and attractive smile, restoration of the interproximal papilla has become one of the most popular demands, thanks to new techniques and instruments. However, according to the different types of techniques proposed, practitioners need to know which alternative will be the most suitable for their patients. AIM: To study non-surgical and surgical treatment modalities recommended for papilla preservation and reconstruction, then, to identify if the perfect therapeutic technique exists. The sub-aim is to review the definition of the dental papilla, and the aetiological factors involved in its loss. The last part is to find out the multiple factors that should be taken in account in order to be performing an aesthetically and functionally adequate papilla Restoration. METHODS: Electronic research of publications made using the electronic databases Medline and PubMed following specific keywords: “gingival papillae”, “anatomy”, “restore”, “preservation”, “interproximal papillae”, “reconstruction” and “technique”. Over that, a selection of case reports, prospective studies and reviews was made in order to have a large panel of comparison. DISCUSSION: Practitioners’ choice and ability to select a specific option well adapted to a clinical case is the success depending factor. All the techniques are satisfying while correctly handled and selected according to patients. Facing one case or another, a proper restoration will be made focusing on the ability of the practitioner and the patient’s type of papilla. CONCLUSION: Without mentioning oral hygiene considerations, all the techniques seem to be very successful but with varying durability over time. Each clinical case is different and need to be analysed in order to use the most satisfactory technique. One of the best surgical techniques seems to be the autologous bone graft with the subepithelial connective tissue. According to all techniques, we keep in mind that in surgical dentistry, the less traumatic, the better papilla regeneration.