Black triangle (dentistry)

The title of this article is ambiguous. For the meaning as a border region between Germany, Poland and Czechoslovakia, see black triangle .

"Black triangles" in the anterior region of the upper jaw

The gingival papillae completely fill the approximal space in healthy teeth.

Under a black triangle ( English black triangle disease ) is understood in dentistry appears dark triangles between the front teeth due gappy standing teeth of a diastema or because of a missing or geschwundenen papilla have emerged. The space between the approximal contact, the physiological contact area between two adjacent teeth , and the gum line is called the approximal space (also: interdental space). The adjacent tooth crowns touch at the proximal contact. In healthy teeth, the approximal space is filled by the papilla.

Basics

When creating or restoring a natural, attractive appearance of the front teeth, a distinction is made between the white aesthetics and the red aesthetics . The restoration of the hard tooth substance in terms of color, shape and tooth position is part of white aesthetics . The red aesthetic tries to preserve or restore the surrounding soft tissue, the gums - especially the gingival papillae. The reconstruction of a lost interdental papilla is one of the most difficult challenges in modern aesthetic dentistry. In addition, the permeability for air or saliva and the accumulation of food residues are perceived as disturbing.

causes

The loss of the papilla is often a result of periodontitis . The gingivitis leads to attachment loss and interproximal bone resorption. The loss of the papillae can also be a result of periodontal surgical therapies. In particular, the soft tissues shrink during the healing phase.

Papilla index

The Italian dentist Daniele Cardaropoli developed a papilla presence index with which the appearance of the papillae can be described.

Papilla Presence Index (PPI)

Degree	Expression
PPI 1	Papilla completely present; reaches to the contact point; same papilla height as adjacent papillae
PPI 2	Papilla not completely present; is apical to the point of contact; not at the same level as the adjacent papillae
PPI 3	Papilla reduced present; The enamel-cement border of the tooth becomes visible interdentally
PPI 4	Papilla hardly present; The enamel-cement boundary of the tooth is visible interdentally and orally

therapy

Surgical and conservative procedures are being developed to rebuild the papillae.

Individual evidence

1. ↑ P. Gehrke, A. Strohecker, G. Dhom, Influence of the interdental papilla length and position of the interapproximal contact on the perception of aesthetics in symmetrical and asymmetrical situations , ZZI, Zweischrift für zahnärztliche Implantologie Heft 3 (2010), pp. 230–246. doi : 10.3238 / ZZI.2010.0230 . Retrieved February 23, 2017.
2. ^ ^{A b} V. P. Singh, AS Uppoor, DG Nayak, D. Shah: Black triangle dilemma and its management in esthetic dentistry. In: Dental research journal. Volume 10, number 3, May 2013, pp. 296-301, PMID 24019795 , PMC 3760350 (free full text) (review).
3. ↑ D. Cardaropoli, S. Re, G. Corrente: The Papilla Presence Index (PPI): a new system to assess interproximal papillary levels. In: The International journal of periodontics & restorative dentistry. Volume 24, Number 5, October 2004, pp. 488-492, PMID 15506030 .
4. ↑ David Clark, "Disappearing Black Triangles". Restoratively controlled papillary regeneration , ZWP. Retrieved February 22, 2017.

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !