The use of radiographs to assess the impact of the distance between the contact area and the crest of the bone to predict the presence or absence of interdental papilla: an in vivo study

Br Dent J. 2023 Aug 21. doi: 10.1038/s41415-023-6184-z. Online ahead of print.

Abstract

Introduction Black triangles (interdental papilla) pose an aesthetic problem for both the patient and the clinician. They also can have an impact on phonetics and periodontal health. It is useful to predict the presence of a black triangle to inform the patient of potential aesthetic compromises. The aim of this study to assess whether the risk of black triangle formation can be predicted using radiographs.Material and methods In total, 404 interproximal sites from 80 random patients attending for a periodontal assessment were measured after radiographs were digitised. The percentage of black triangles within the range of measurements of the crestal bone to the contact area from <5 mm up to 8 mm and over was then calculated.Results At a distance of 5 mm or less, the papilla was present 87.5% of the time. At 6 mm, a black triangle was present 51.4% of the time, and at 7 mm or greater, a black triangle was present 72.7% of the time. When these results were compared to other studies that had different criteria and methods, they were all very similar.Conclusion Using radiographs appears to be useful in assessing the presence or absence of a black triangle in patients who are assessed for periodontal disease, prosthetic replacement, implants in the aesthetic zone, or cosmetic treatment.