Efficacy of HA Gel Injection Versus Multilayer (L-PRF) in the Interdental Papilla Reconstruction
Condition: Gingival Papillary Cratering
Study type: Interventional

Summary: 
      This research aims to investigate the effectiveness of non invasive application Hyaluronic
      acid gel injection versus minimally invasive surgical approach using multilayer L-PRF both
      clinically and radiographically as a suitable treatment modality for interdental papillary
      deficiency.
    

Detailed description: 
      A total of 20 patients recruited from the outpatient clinic of Oral Medicine, Periodontology
      and Oral Diagnosis department, Faculty of Dentistry, Ain-Shams University and seeking
      treatment for black triangles for esthetic reason. Patients meeting the eligibility criteria
      are equally and randomly allocated in two different groups. group one Included 10 patients
      who received interdental papillary reconstruction using multiple layers of L-PRF. Group two
      Included 10 patients who received interdental papillary reconstruction using Hyaluronic acid
      gel injection. In the follow-up phase, patients were recalled after 3 and 6 months from
      intervention where clinical re-measurement of the black triangles and standardized digital
      clinical photographs and radiographs are done. Black triangle height and surface area was
      measured and other clinical parameters (Modified papillary bleeding index, Gingival index,
      clinical attachment level and periodontal probing depth) were assessed at baseline, 3 months
      and 6 months periods. patient satisfaction was evaluated using the patient satisfaction
      questionnaire (PSQ-18, short form) at baseline. pain and discomfort was evaluated using
      Numerical rating scale (NRS) at baseline, 3 months and 6 months periods. Global esthetic
      improvement scale (GAIS) was evaluated at 3 months and 6 months periods.
    

Intervention name(s): Hyaluronic acid gel; Multilayer L-PRF membranes
Intervention type(s): Combination Product; Combination Product
Intervention description(s): For the Hyaluronic acid gel group: HA gel was injected 2-3mm apical to the coronal tip of the involved papillae and the needle was directed coronally with an angulation of 45° to the long axis of the tooth, and the bevel directed apically until papilla became blanched. The injection was given at each papilla at the following intervals baseline, one week and two weeks.; For the multilayer L-PRF group: A single semilunar incision is made in the buccal vestibule, apical to the muco-gingival junction in the mid interproximal area of the papilla to be treated.Tunneling of the incisions has maintained the full height and thickness of the gingiva. Multilayer L-PRF membranes were prepared according to Pinto's protocol immediately prior to the surgery and placed in the tunnel then incision was closed with simple interrupted sutures.
Other intervention name(s): HA gel
Intervention MeSH terms: Hyaluronic Acid
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: this study is designed as a parallel randomized controlled clinical trial
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: interdental papilla; multilayer L-PRF; Hyaluronic acid gel