• Journal of the Korean Academy of Esthetic Dentistry
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• v.10 no.1
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• pp.30-45
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• 2001

In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.30 no.2
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• pp.91-101
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• 2021

The interdental papilla area is a difficult area for connective tissue graft (CTG) due to its narrow space. So Regeneration of interdental papilla is very challenging work. It is very difficult when the teeth have contact with adjacent teeth, but if there was only 3mm of space between the teeth, CTG was not very difficult. Therefore, through the orthodontic force, a 3mm space between the teeth was intentionally created. The CTG was performed using a microblade, and only one vertical incision was performed off the gingival margin, and the graft was performed by inserting the grafts through here. After a period of maintenance, I was able to gather the teeth again with orthodontic force and regenerate the interdental papilla. I named this technique ELSA Technique (Enlargement of space - Labial graft - Squeezing - for Augmentation of papilla). If interdental papilla is lost due to periodontal disease, ELSA techniques can regenerate interdental papilla very efficiently.

• Journal of the korean academy of Pediatric Dentistry
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• v.7 no.1
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• pp.53-61
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• 1980

The purpose of this study was to statistically evaluate the spacing of primary dentition according to whether or not a space existed and measurement of amount of space in 205 children (male 114, female 91) from 2 to 6 years of age. The results were as follows; 1. In the incidence of interdental space on each region, spacing between the primary lateral incisors and primary canine in maxilla and between the primary canine and 1st primary molar in mandible showed the highest percentage, on the other hand, spacing between the 1st and 2nd primary molars in both jaw showed the lowest percentage. 2. In the kinds of interdental space, the state of primate space and other space together showed the highest percentage, and in the degree of spacing, $S_2$ showed the highest percentage in both jaw. 3. In the incidence of primate space, maxillary primate space showed higher percentage than mandibular primate space in bilateral case. 4. In the type of arch form, spaced arch showed higher percentage than closed arch and about the half of closed arch showed crowding. 5. In both Jaw, available space showed incisor segments, canine segments, and premolar segments in order of amount, and there were not statistically significant differences of sex or jaws in the amount of available space.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.3
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• pp.387-393
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• 2009

The purpose of this study was to assess the relationship between interdental spaces and proximal caries in maxillary anterior primary teeth. 555 children aged 3-7 inhabit in Iksan were divided into two groups, depending on the presence of interdental space which was detected by a dental explorer. They were determined to have proximal caries if cavity was formed or the enamel surface was softened. The results were as follows : 1. Regarding interdental spaces, 77.4% had primate spaces; 54.4% had developmental spaces between central and lateral incisor, and 39.0% between central incisors. 2. Interproximal caries incidences in right primary canine, lateral incisor, and central incisor were 6.3%, 14.7%, and 33.5%, respectively. Also interproximal caries incidences in left primary central incisor, lateral incisor, and canine were 33.7%, 16.0%, and 4.7%, respectively. 3. Children with more interdental spaces had less caries incidence, but the relationship was weak(r=-0.024). 4. The mean caries incidence was higher in absence of interdental space of maxillary primary incisors than in presence of space. The mean caries incidence with no interdental space was twice as high as that with presence of interdental space.

• Journal of Periodontal and Implant Science
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• v.28 no.2
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• pp.321-337
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• 1998

The aims of this study were firstly to investigate soft tissue reactions around single implant-supported crowns and secondly to compare soft tissue dimensions and conditions of the crowns in relation to interdental papillae, and lastly to investigate patients'esthetic satisfaction with their single implant-supported crowns according to the interdental papillae presence/absence. Twenty-nine patients (41 implants) whose single missing tooth in the maxillary anterior region had been replaced by single implant-supported crown participated for the study and various variables of soft tissue conditions, dimensions and crown dimensions were measured around the single implant-supported crowns at clinical examination and from study models and slides. The results showed that the soft tissue conditions around the single implantsupported crowns were similar to those around implants used for partially or totolly edentulous patients. Except for the high frequency of bleeding on probing, all other parameters revealed healthy conditions. The buccal sites of the crown had a shallow pocket comparing with other sites. At all sites of the crown, similar status of little inflammation was found. Mesial sites and central-incisor positioned implantsupported crowns had lower contact point position than distal sites and lateral-incisor positioned crowns, respectively. Mucositis index, probing depth and contact point position were significantly correlated with papillae index(p < 0.05). More inflammation and lower contact point position were found at the implant-supported crown with no interdental space than that with interdental space. Patients showed high esthetic satisfaction regardless of interdental space presence. The result indicated that, despite of their submucosal crown margins, single implantsupported crowns have soft tissue conditions as good as other implants used for the treatment of the different types of edentulism and a clinician can manipulate interdental papilla height by modifying crown shapes within the limits of not violating total esthetics.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.29 no.2
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• pp.84-91
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• 2020

Regeneration of interdental papilla damaged by periodontal disease is a very challenging task. So far, many dentists have devised and introduced great surgical methods. Comparing the pros and cons of the methods introduced so far, I came up with the best way to regenerate interdental papilla. Temporarily creating space between narrow interdental papilla, which cannot be solved by periodontal surgery alone, was a great help for connective tissue graft(CTG). The CTG was performed using a microblade, and only one vertical incision was performed off the gingival margin, and the graft was performed by inserting the grafts through here. Along with the orthodontic treatment, the area between the narrow interdental papilla was widened to make it easier for the CTG was carried out. After a period of maintenance, I was able to gather the teeth again with orthodontic force and regenerate the interdental papilla. I named this method ELSA (Enlargement of space-Labial graft-Squeezing-for Augmentation of papilla) technique.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.31 no.2
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• pp.56-63
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• 2022

The mandibular 4 anterior incisor restoration has small teeth and a small space, so the choice of abutment is always a concern. The mandibular 4 anterior incisor extraction is caused by periodontal disease, interdental embrasure greatly open is advantageous of oral hygiene management. Try to make it small diameter with custom abutment, it is limited to the space for the screw. Rather than setting the post site of one body implant to a horizontal cross-section, it is advantageous to set it to a longitudinal cross-section, for interdental embrasure formation. When using an internal bone level implant, rather than using a two-piece abutment, using a one-piece abutment can more effectively secure space for interdental embrasure.

• The Journal of Advanced Prosthodontics
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• v.2 no.2
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• pp.61-63
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• 2010

If orthodontists and restorative dentists establish the interdisciplinary approach to esthetic dentistry, the esthetic and functional outcome of their combined efforts will be greatly enhanced. This article describes satisfying esthetic results obtained by the distribution of space for restoration by orthodontic treatment and porcelain laminate veneers in uneven space between maxillary anterior teeth. It is proposed that the use of orthodontic treatment for re-distribution of the space and the use of porcelain laminate veneers to alter crown anatomy provide maximum esthetic and functional correction for patients with irregular interdental spacing.

• The Journal of the Korean dental association
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• v.15 no.1
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• pp.41-45
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• 1977

For biometric study on the widlth of mouth in singaporian the author measured the transversal width of mouth, Longitudinal width of mouth and Interdental space in 652 cases of the total cases 317 were male (chinese 235. malay50, Indian 32) and 335 Female (Chinese 260, malay 53. Indian 22) and Ages ranged from 5 to 25 yeass old. The fallowing result was obtained. 1) In Adult, transversal width of mouth was 54. 20±0.22mm in male, 53.00±0.10mm in female and 40.03±0.26mm in male, 39.39±0.30mm in female of children. 2) In Abult, Longitudinal width of mouth was 52.00±0.12mm in male, 48.40±0.15mm in female and 44.50±0.13mm in male 44.20±0.30mm in female of children. 3) In Adult, Interdental Space (anterior teeth) was 44.20±0.15mm in male. 44.00±0.20mm in Fmale and 38.40±0.15mm in male, 37.17±0.21mm in Female of Children.

• Journal of Periodontal and Implant Science
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• v.41 no.6
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• pp.273-278
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• 2011

Purpose: To analyze the dimensions of the embrasure space between the maxillary central incisors as potential factors influencing interdental papilla fill and height. Methods: The embrasure dimensions between the maxillary central incisors of 100 subjects (40 females/60 males) were assessed with clinical, study model, and radiographic examinations. Variables of the complete and deficient papilla fill groups were compared. Multiple regression analyses were performed to investigate potential influence of the distance between the contact point and bone crest (CP_BC), horizontal interdental distance (HID), and facio-lingual thickness (FLT) at the papilla base on complete/deficient papilla fill and papilla height (PH). Results: CP_BC was the only variable that showed a significant difference between the complete and deficient papilla groups (P<0.05). When the CP_BC was less than 5 mm, the embrasure spaces between the maxillary central incisors were completely filled with interdental papilla. Multiple regression analyses revealed that a significant predictor for complete/deficient papilla fill was CP_BC, and significant predictors for PH were CP_BC and HID (P<0.05). Conclusions: The chances of complete papilla fill increased as CP_BC decreased, while PH increased as CP_BC and HID increased. However, the FLT of the papilla base did not appear to affect papilla fill or PH. From an esthetic perspective, CP_BC as well as HID should be considered as factors influencing the topography of interdental papilla.