Hyaluronic Acid: Ray of Hope for Esthetically Challenging Black Triangles: A Case Series

PURPOSE: The purpose of this study is to evaluate the clinical efficacy of enhancing deficient interdental papilla with hyaluronic acid gel injection. MATERIALS AND METHODS: Eight patients (three males and five females) were included. Patients had papillary deficiency in the upper anterior area. Prior to treatment, photographic images were taken for each patient. After the administration of a local anesthetic, a 23G needle was used to inject <0.2 mL of a commercially available and Food and Drug Administration-approved hyaluronic acid gel this treatment was repeated up to 2–3 times. Clinical photographic measurements of the black triangle area (BTA), black triangle height, and black triangle width were undertaken before the treatment and during follow-up. The interdental papilla reconstruction rate was calculated to determine the percentage change of the BTA between the initial and final examinations of the interdental papilla by means of injectable hyaluronic acid gel were evaluated. RESULTS: Eight sites had complete interdental papilla reconstruction and six sites showed improvements ranging from 78.5 ± 19.83%. More specifically, when contact point and the bone crest reached 6 mm, virtually complete interdental papilla reconstruction was achieved. CONCLUSIONS: The results from this study are encouraging and present evidence that small papillary deficiencies between teeth can be enhanced by the injection of a hyaluronic acid gel.