The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 9 , ISSUE 6 ( September, 2008 ) > List of Articles

RESEARCH ARTICLE

The Dilemma of the Open Gingival Embrasure Between Maxillary Central Incisors

Bruno D'Aurea Furquim, Renata Corrêa Pascotto, Gerson Luiz Ulema Ribeiro, José Antonio Bósio, Hiroshi Maruo

Citation Information : Furquim BD, Pascotto RC, Ribeiro GL, Bósio JA, Maruo H. The Dilemma of the Open Gingival Embrasure Between Maxillary Central Incisors. J Contemp Dent Pract 2008; 9 (6):92-98.

DOI: 10.5005/jcdp-9-6-92

License: CC BY-NC 3.0

Published Online: 01-05-2010

Copyright Statement:  Copyright © 2008; The Author(s).


Abstract

Aim

The aim of this report is to present the etiology, diagnosis, and treatment planning strategy in the presence of an open gingival embrasure between the maxillary central incisors.

Background

The open gingival embrasure or “black triangle” is a visible triangular space in the cervical region of the maxillary incisors. It appears when the gingival papilla does not completely fill in the interdental space. The space may occur due to: (1) disease or surgery with periodontal attachment loss resulting in gingival recession; (2) severely malaligned maxillary incisors; (3) divergent roots; or (4) triangular-shaped crowns associated with or without periodontal problems and alveolar bone resorptions.

Report

The post-treatment prevalence in adult orthodontic patients is estimated to be around 40% compromising the esthetic result.

Conclusion

Several methods of managing patients with open gingival embrasure exist, but the interdisciplinary aspects of treatment must be emphasized to achieve the best possible result. The orthodontist can play a significant role in helping to manage these cases.

Clinical Significance

Various treatment strategies are available to treat cases of an undesirable black triangle and are dependent on the etiology of the condition.

Citation

Tanaka OM, Furquim BD'A, Pascotto RC, Ribeiro GLU, Bósio JA, Maruo H. The Dilemma of the Open Gingival Embrasure Between Maxillary Central Incisors. J Contemp Dent Pract 2008 September; (9)6:092-098.


PDF Share
  1. An analysis of maxillary anterior teeth: facial and dental proportions. J Prosthet Dent 2005; 94:530-8.
  2. Open gingival embrasures after orthodontic treatment in adults: Prevalence and etiology. Am J Orthod Dentofacial Orthop 2001; 120:116-23.
  3. Incidence and size of pretreatment overlap and posttreatment gingival embrasure space between maxillary central incisors. Am J Orthod Dentofacial Orthop 1994; 105:511.
  4. Esthetics: the orthodontic-periodontic restorative connection. Semin Orthod 1996; 2:21-30.
  5. Comparing the perception of dentists and lay people to altered dental aesthetics. J Esthet Dent 1999; 11:311-24.
  6. Some factors associated with open gingival embrasures following orthodontic treatment. Aust Orthod J 2003; 19:19-24.
  7. The future of orthodontics. Belgium: Leuven University Press; 1998.
  8. Effect of maxillary incisor angulation and inclination on arch length. Am J Orthod Dentofacial Orthop 1987; 91:233-9.
  9. Anterior interocclusal relations. Part I. Am J Orthod 1980; 78:361-70.
  10. Clinical Periodontology and Implant Dentistry – Jan Lindhe. 4th ed. 2005;576p.
  11. The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla. J Periodontol 1992; 63:995-6.
  12. Principles of cosmetic dentistry in orthodontics: Part 1. Shape and proportionality of anterior teeth. Am J Orthod Dentofacial Orthop 2004; 126:749-53.
  13. Estética e cosmética na clínica integrada restauradora. São Paulo: Quintessence Ed; 2003.
  14. Semin Orthod 1997; 3:3-20.
  15. Prediction and causes of open gingival embrasure spaces between the mandibular central incisors following orthodontic treatment. Aust Orthod J 2004; 20:87-92.
  16. Periodontal condition in orthodontically treated individuals. II Alveolar bone loss: radiographic findings. Angle Orthod 1974; 44:48-55.
  17. Alveolar bone loss of maxillary anterior teeth in adult orthodontic patients. Am J Orthod Dentofacial Orthop 1997; 111:328-34.
  18. Principles of Esthetic Integration. São Paulo:Quintessence Pub Co;2000.
  19. Maximizing anterior esthetics: an interdisciplinary approach. In McNamara JA Jr, editor. Frontiers in dental and facial esthetics. Craniofacial Growth Series. Ann Arbor: Center for Human Growth and Development. University of Michigan:Needham Press; 2001. p.1-18.
  20. Mucogingival Therapy – Periodontal Plastic Surgery. Clinical Periodontology and Implant Dentistry – Jan Lindhe. 4th ed 2005;576p.
  21. Laser irradiation inhibition of open gingival embrasure space after orthodontic treatment. Aust Orthod J 2002; 18:53-63.
  22. Surgical reconstruction of interdental papilla using an interposed subepithelial connective tissue graft: a case report. Int J Periodontics Restorative Dent 2004; 24:31-7.
  23. Controlled orthodontic extrusion to create gingival papilla: a case report. Quintessence Int 2002; 33:561-5.
  24. Reconstruction of the maxillary midline papilla following a combined orthodontic-periodontic treatment in adult periodontal patients. J Clin Periodontol 2004; 31:79-84.
  25. Interproximal papilla augmentation procedure: a novel surgical approach and clinical evaluation of 10 consecutive procedures. Int J Period Res Dent 2001; 21:553-9.
  26. Periodontal characteristics in individuals with varying form of the upper central incisors. J Clin Periodontol 1991; 18:78-82.
  27. Alveolar bone anatomic profiles as measured from dry skulls. Clinical ramifications. J Clin Periodontol 1997;24:727-31.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.