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Local Injection of Hyaluronic Acid Filler Improves Open Gingival Embrasure: Validation Through a Rat Model

 Soojin Pi  ;  Yoon Jeong Choi  ;  Soonshin Hwang  ;  Dong‐Won Lee  ;  Jong In Yook  ;  Kyung‐Ho Kim  ;  Chooryung J. Chung 
 JOURNAL OF PERIODONTOLOGY, Vol.88(11) : 1221-1230, 2017 
Journal Title
Issue Date
Biocompatible materials ; gingiva ; orthodontics ; research design ; tooth movement techniques
BACKGROUND: The open gingival embrasure, the so-called black triangle, is one of the unsolved dilemmas in adult dentistry. Although various techniques have been introduced to improve black triangles, the lack of reproducible experimental models has prevented development of successful protocols to regenerate or to compensate loss of the interdental papilla. Therefore, the objective of this study is first to develop a reliable animal model of open gingival embrasure and then to validate a minimally invasive injection technique using hyaluronic acid (HA) filler to augment the interdental papilla.

METHODS: To reproduce open gingival embrasure in rats, rapid space opening was induced between the mandibular incisors by attachment of a compression spring. Loss of interdental papilla height was morphologically evaluated and calculated using standardized serial photographs, microcomputed tomography, and histologic sections. Afterward, HA fillers or phosphate-buffered saline (PBS) was locally injected, and changes in the interdental papilla were evaluated.

RESULTS: After 7 days of space opening, the margin of the interdental papilla between the mandibular incisors gradually became irregular and flat, indicating a condition similar to the open gingival embrasure (P <0.05). Local injection of HA filler induced an augmentation effect of the interdental papilla compared with injection of PBS (P <0.05). Interdental papilla became convex, and inner granules containing HA were detected within the submucosal layer after its injection.

CONCLUSIONS: Open gingival embrasure was reproduced reliably in vivo. Local injection of HA filler was validated as a meaningful minimally invasive procedure to improve open gingival embrasure.
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2. College of Dentistry (치과대학) > Dept. of Oral Pathology (구강병리학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Orthodontics (교정과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Periodontics (치주과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Ho(김경호) ORCID logo https://orcid.org/0000-0002-8154-2041
Yook, Jong In(육종인) ORCID logo https://orcid.org/0000-0002-7318-6112
Lee, Dong Won(이동원) ORCID logo https://orcid.org/0000-0003-1852-7989
Chung, Chooryung J.(정주령) ORCID logo https://orcid.org/0000-0001-9399-7193
Choi, Yoon Jeong(최윤정) ORCID logo https://orcid.org/0000-0003-0781-8836
Hwang, Soon Shin(황순신) ORCID logo https://orcid.org/0000-0002-6472-4732
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