Abstract
The black triangle resulting from interdental papilla (IDP) loss is associated with poor aesthetics and difficulty in pronunciation and food impaction. There is limited knowledge of gingival tissue inflammatory response to hyaluronic acid (HA) filler injection, a minimally invasive IDP reconstruction method. This study aimed to examine the morphological and histological changes in IDP and the inflammatory cytokine localization to the IDP post-HA filler injection using an open gingival embrasure (OGE) mouse model. Mice from the control, sham, and OGE groups were attached with reference, inactive, and activated wires for 5 days, respectively. The degree of IDP loss was determined based on the spring-papilla distance (SPD). Morphological and histological changes in the OGE group injected with phosphate-buffered saline (PBS) or HA fillers were examined on days 2 and 7 post-injection. Immunohistochemical analysis was performed to determine the localization patterns of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, myeloperoxidase (MPO), and Ki67. Five days post-wire attachment, the control and OGE groups exhibited a significantly higher SPD than the sham group (p < 0.0167). The SPD of the HA filler injection group was significantly lower than that of the PBS injection group on days 2, 4, and 7 post-injection (p < 0.05). The IDP of the OGE group was wide and flat. HA filler was stable in the connective tissue underlying the epithelial tissue even on day 7 post-injection. TNF-α, IL-1β, IL-6, MPO, and Ki67 were highly localized to the connective tissue surrounding the filler on day 2, which decreased on day 7 post-injection. Thus, HA filler can safely and successfully reconstruct the IDP in cases of OGE.
Highlights
The gap between two teeth is filled by the interdental papilla (IDP), a triangular gingival tissue [1].Various factors contribute to the loss of IDP, such as loss of attached gingiva due to the absorption of alveolar bone, periodontal disease, poor shape reconstruction, and abnormal tooth alignment
This study aimed to evaluate the safety of intra oral application of hyaluronic acid (HA) filler using a mouse model of open gingival embrasure (OGE) through examination of the localization pattern of inflammatory cytokines, such as tumor necrosis factor (TNF)-α, IL-1β, IL-6, and MPO, in the injected IDP
This study demonstrated an in vivo model of IDP loss and the reconstruction of the IDP
Summary
The gap between two teeth is filled by the interdental papilla (IDP), a triangular gingival tissue [1].Various factors contribute to the loss of IDP, such as loss of attached gingiva due to the absorption of alveolar bone, periodontal disease, poor shape reconstruction, and abnormal tooth alignment. The gap between two teeth is filled by the interdental papilla (IDP), a triangular gingival tissue [1]. The IDP loss-induced gap between the teeth is called a black triangle, which affects tooth aesthetics in the anterior maxillary region and causes various forms of discomfort, such as difficulty in pronunciation and food impaction between the teeth [2]. The loss of IDP is an important concern for dentists and patients. Various surgical methods, such as free gingiva and connective tissue graft, and flap design surgery, have been proposed to restore IDP loss.
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