Black Triangles Causes and Management: A Review of Literature

  title={Black Triangles Causes and Management: A Review of Literature},
  author={Mohd G. Sghaireen and Wala'a M. AlOmari and H. Bheran and Ibraheim Mohyeldin Taher},
  journal={British Journal of Applied Science and Technology},
Open gingival embrasures often pose complex functional and esthetic problems. [] Key Method The authors reviewed a total of 51 articles including review of the literature using the terms ‘black triangle’; ‘open gingival embrasure’; ‘interdental papilla’ and interproximal contact area’. These articles provided information regarding etiology, diagnosis, and management of black triangles . There are several risk factors leading to the development of black triangles. These factors include periodontal disease…

Figures and Tables from this paper

Black Triangles and its Management- A Review

This review was carried out after electronic searches in databases such as PubMed, PubMed Central, MEDLINE, Google Scholar, and MeSH were done and studies included ranged from a time period of 1992–2016 and included clinical trial researches.


It was concluded that both fillers were biocompatible and safe for treatment of interdental papilla deficiency, though, Radiesse gel was more effective and long-lasting compared with hyaluronic acid.

Aesthetic Crown Lengthening With Anterior Maxillary Osteotomy for Achieving Ideal Clinical Crown Length: A Case Report

Crown lengthening is an effective treatment in correcting dysfunctions and aesthetics due to altered passive eruption by performing crown lengthening with an osteotomy to achieve ideal clinical crowns and restore the functions and aesthetics.

Analysis of Crown Morphology and Gingival Shape in the Maxillary Anterior Dentition.

Gingival phenotypes according to tooth and gingival parameters, as well as the relationships between tooth shape and gingingival characteristics, such as the papillary height (PH) and faciolingual thickness (FLT) of the papilla base, are categorized.

Potency of hyaluronic acid from eggshell–membrane for open gingival embrasure reconstruction following orthodontic tooth movement (a histomorphological study)

ESM has the potential effect of regenerating the interdental papilla construction after OTM by increasing the collagen fiber density and inducing angiogenesis.

Assessment of Hyaluronic Acid Gel Injection in the Reconstruction of Interdental Papilla: A Randomized Clinical Trial

The use of hyaluronic acid gel for the reconstruction of interdental papillary deficiency was effective with promising levels of patients’ satisfaction and a statistically significant higher mean satisfaction score than the saline group.

Regenerative Surgical Flap to Maintain Interdental Papilla around Dental Implant

A modification in the surgical technique has been employed with the intention to preserve the interdental papilla, which is the key to the maintenance of hygiene and esthetics around anterior implants, which prevents black triangles and improves soft-tissue contours.

Smile perception amongst orthodontists and laypersons

It was concluded that there are differences in layperson’s and orthodontists perception of smile on the basis of gingival show.

Comparison of Connective Tissue Graft and Platelet Rich Fibrin as Matrices in A Novel Papillary Augmentation Access: A Randomized Controlled Clinical Trial

The study demonstrates that the proposed papillary augmentation access withCTG and PRF was successful in managing the unaesthetic interdental papillary loss, with CTG showing better results in terms of reduction of black triangle than PRF.

Use of Hyaluronic Acid in Black Space

This poster presents a probabilistic procedure to evaluate the response of the enamel of the maxillofacial molars to the laser-spot assisted chemoreception technique.



Esthetic considerations in interdental papilla: remediation and regeneration.

  • A. SharmaJae Hyun Park
  • Medicine
    Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.]
  • 2010
The authors reviewed a total of 42 articles including review of literature, radiographic, cross-sectional, and retrospective studies in Ovid search engine using the terms "open gingival embrasure," "interdental papilla," and "black triangle" to provide information regarding etiology, diagnosis, and treatment of open embrasures.

The dilemma of the open gingival embrasure between maxillary central incisors.

The etiology, diagnosis, and treatment planning strategy in the presence of an open gingival embrasure between the maxillary central incisors is presented and the orthodontist can play a significant role in helping to manage these cases.

Interdental papilla management: a review and classification of the therapeutic approaches.

Some factors associated with open gingival embrasures following orthodontic treatment.

Open gingival embrasures were more frequently found in patients over 20 years of age than in younger patients, and were associated with resorption of the alveolar crest.

A modified papilla preservation technique, 22 years later.

The aims of the present article are to report a 22-year follow-up case of surgical interdental papilla preservation, discuss the anatomic variables that conditioned the outcome, and review and compare existing surgical techniques for maintaining the interproximal soft tissues.

Management of inter-dental/inter-implant papilla.

An esthetic triangle is developed to address the foundations that are essential for maintaining/creating papilla, which include adequate bone volume, proper soft tissue thickness as well as esthetic appearing restorations.

Open gingival embrasures after orthodontic treatment in adults: prevalence and etiology.

  • J. KurthV. Kokich
  • Medicine
    American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics
  • 2001
It is indicated that open gingival embrasures are common in adults who have undergone orthodontic treatment and that posttreatment variables are significant factors in open gingingival embrasure.

Incidence and size of pretreatment overlap and posttreatment gingival embrasure space between maxillary central incisors.

  • S. BurkeJ. BurchJ. Tetz
  • Medicine
    American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics
  • 1994

Surgical reconstruction of the interdental papilla.

Three case reports demonstrate a proposed surgical technique for the reconstruction of collapsed interdental papillae using a connective tissue graft under the buccal and palatal flaps.

Comparing the perception of dentists and lay people to altered dental esthetics.

The results of this study show that orthodontists, general dentists, and lay people detect specific dental esthetic discrepancies at varying levels of deviation, which may aid the dental professional in making specific treatment recommendations.