From a periodontal viewpoint, the gingival embrasure is the most significant.
Periodontal diseases cause tissue destruction, which reduces the level of alveolar bone, increases the size of the gingival embrasure, and creates an open interdental space.
A black triangle or an open gingival embrasure occurs as a result of a deficiency or loss of papilla beneath the contact point.
Today, in majority of the adult population with a history of periodontal disease, open gingival embrasures are a common problem.
Open Gingival Embrasures after Orthodontic Treatment in Adults: Prevalence and Etiology.
The first option consisted of an orthodontic retreatment for diastema closure and papilla reconstruction with a surgical technique for correction of the open gingival embrasure. With orthodontic tooth movement, appropriate crown-root angulation, incisal level, and gingival zenith position for final restorations can be achieved.
There was about 1.5-2 mm of the open gingival embrasure remaining between teeth, measured from the tip of the interdental papilla to the contact point (Figure 3(b)).
At a 1-month follow-up after the last injection, about 1 mm open gingival embrasure or black triangle space in the cervical region remained.
The proximal margin was extended into the facial and gingival embrasures
However, periodontal dis- ease may lead to bone loss and soft tissue loss resulting in enlarged gingival embrasures
and increased crown length causing esthetic problems.l-3 Another problem for the clinician related to gingival recession is hyper- sensitivity.3,4 High prevalence values for sensitivity of root surfaces, ranging from 60.3% to 98%4-7 have been reported as a part of the periodontal disease process.1,4
The interdental open gingival embrasures
were accurately reproduced in the final impression using addition silicone impression material (Reprosil, Regular Body, Dentsply, USA) in an acrylic custom tray (DPI, Self-cure, India) that extended from incisal edges to vestibular sulcus in the maxillary anterior region (Figure 2).
The patient had a medium smile line and the gingival embrasures
were visible during smiling.