黑三角 (牙科)

黑三角（英語：Black triangle，拉丁語：Angularis nigra），也称为开放性牙龈楔状隙、開放性牙間楔狀隙（英語：open gingival embrasures），是位于齒頸側齒斜隙、位于牙齿接触点下方的空间或和间隙，因牙齦乳頭不能完全填滿空间，而导致相邻牙齿之间出现的缝隙。 这种间隙有很多成因，包括牙龈萎缩、矯齒治疗后牙龈退缩。 黑三角被评为龋齿和牙冠高度之外最令人讨厌的美观问题。 治疗黑三角通常涉及牙周、矯齒和修复治疗。矫正黑三角的方法包括在间隙中添加复合树脂、 使用牙齒貼片或移植牙龈。 黑三角一般仅根据患者的美學要求进行治疗 ，不過严重的牙龈萎缩可能需要进行進一步的牙周治疗。 有几个风险因素会导致黑三角的形成。牙齦乳頭尺寸可能由于以下任何原因而改变： 1.牙齿之间的邻间隙：当两隻牙的临床牙冠之间的接触点位置过斜时，牙根角度不良会导致间隙的存在，牙根角度不良也可能是矯齒治疗的结果。 2.牙冠接触点與牙槽骨之间的距离增加：例如自然发生的牙間隙 和牙槽骨流失。 3.牙龈厚度；厚牙齦和薄牙齦通常对炎症和创伤有不同的反应， 薄牙龈在牙齒修复、牙冠修形、牙周手術及植齒后更容易萎缩。 4.年龄：牙龈随着年龄增长而萎缩。 5.牙周疾病，导致牙龈萎缩。 6.异常的牙冠和牙齒形態及牙齒修复形状；呈三角形的临床牙冠往往会导致间隙。 Burke, S; Burch, J; Tetz, J. Incidence and size of pretreatment overlap and posttreatment gingival embrasure space between maxillary central incisors. American Journal of Orthodontics and Dentofacial Orthopedics. 1994, 105 (5): 506–11. PMID 8166102. doi:10.1016/S0889-5406(94)70013-3.  Ikeda, T; Yamaguchi, M; Meguro, D; Kasai, K. Prediction and causes of open gingival embrasure spaces between the mandibular central incisors following orthodontic treatment. Australian Orthodontic Journal. 2004, 20 (2): 87–92. PMID 16429878.  Cunliffe, Joanne; Pretty, Iain. Patients' ranking of interdental "black triangles" against other common aesthetic problems. The European Journal of Prosthodontics and Restorative Dentistry. December 2009, 17 (4): 177–181. ISSN 0965-7452. PMID 20158060.  Lenhard, M. Closing diastemas with resin composite restorations. The European Journal of Esthetic Dentistry. 2008, 3 (3): 258–68. PMID 19655542.  De Castro Pinto, RC; Colombini, BL; Ishikiriama, SK; Chambrone, L; Pustiglioni, FE; Romito, GA. The subepithelial connective tissue pedicle graft combined with the coronally advanced flap for restoring missing papilla: A report of two cases. Quintessence International. 2010, 41 (3): 213–20. PMID 20213022.  Clark, D. Restoratively driven papilla regeneration: Correcting the dreaded 'black triangle'. Texas Dental Journal. 2008, 125 (11): 1112–5. PMID 19180945.  Cho, Hae-Sung; Jang, Hyun-Seon; Kim, Dong-Kie; Park, Joo-Cheol; Kim, Heung-Joong; Choi, Seong-Ho; Kim, Chong-Kwan; Kim, Byung-Ock. The Effects of Interproximal Distance Between Roots on the Existence of Interdental Papillae According to the Distance From the Contact Point to the Alveolar Crest. Journal of Periodontology. October 2006, 77 (10): 1651–1657. ISSN 0022-3492. PMID 17032106. doi:10.1902/jop.2006.060023.  Portuguese Abstract Translations. Implant Dentistry. October 2014, 23 (5): e87–e93. ISSN 1056-6163. S2CID 220586634. doi:10.1097/id.0000000000000164.  Houston, W. J. B. Textbook of clinical periodontology. Author: Jan Lindhe. Publisher: Munksgaard International Publishers Ltd., Price: D.kr. 460.00. The European Journal of Orthodontics. 1984-08-01, 6 (3): 234. ISSN 0141-5387. doi:10.1093/ejo/6.3.234.  SANAVI, FARSHID; WEISGOLD, ARNOLD S.; ROSE, LOUIS F. Biologic Width and its Relation to Periodontal Biotypes. Journal of Esthetic and Restorative Dentistry. May 1998, 10 (3): 157–163. ISSN 1496-4155. PMID 9759032. doi:10.1111/j.1708-8240.1998.tb00351.x.  Portuguese Abstract Translations. Implant Dentistry. October 2014, 23 (5): e87–e93. ISSN 1056-6163. S2CID 220586634. doi:10.1097/id.0000000000000164.  Chow, Yiu Cheung; Wang, Hom-Lay. Factors and Techniques Influencing Peri-Implant Papillae. Implant Dentistry. 2010, 19 (3): 208–19. PMID 20523177. S2CID 13875737. doi:10.1097/ID.0b013e3181d43bd6.  https://web.archive.org/web/20101219042017/http://www.1stcosmeticdentist.com/restorative-dentistry-article33.html https://web.archive.org/web/20110505195404/http://www.thordarson.ca/black-triangles- Between-tooth