주입형 히알루론산 겔을 통한 치간유두재건술에 대한 임상적 평가

Abstract

Objectives: Today, one of the most challenging aspects in periodontal reconstructive surgery is to obtain predictable interdental papilla in the esthetic zone. Recently a gel of hyaluronic acid has been successfully used to reduce facial creases and various other abnormalities. The purpose of this study is to evaluate the new method for possibly enhancing deficient interdental papilla using an image analysis system and assess factors affecting the reconstruction of interdental papilla with injectable hyaluronic gel.

Materials & Methods: Thirteen patients(6 males and 7 females) with 57 treated sites were included. Patients had papillary deficiency in the upper anterior area. Prior to treatment, standardization photographic devices for each patients were designed. A 30-gauge needle with auto-injector was used to inject a gel of hyaluronic acid 2-3mm apical to the coronal tip of the involved papilla. This treatment was repeated up to five times every three weeks. Patients were followed 6 months after initial gel application. Clinical photographic measurements of black triangle area and periapical radiographic measurements of alveolar bone level and interdental space anatomy were undertaken using computer software. Interdental papilla reconstruction rate was calculated to determine percentage change between initial and final examination and factors influencing the reconstruction of interdental papilla with injectable hyaluronic gel were evaluated.

Results: All sites had improvement between treatment examinations. Thirty six sites had completely interdental papilla reconstruction and twenty one sites improved from 19 to 96%. The distance between the contact point and the bone crest was correlated with interdental papilla reconstruction rate. Especially, when the distance between the contact point and the bone crest was up to 6mm, completely interdental papilla reconstruction was almost achieved.

Conclusion: The results suggest that the use of an injectable hyaluronic gel can be a promising treatment option for enhancing papillary esthetics.