Management of Open Gingival Embrasures: A Scope for Prosthetic Dentistry

Abstract

A smile that is pleasing and beaming can be achieved by appropriate position of tooth, periodontal status of the tooth, type of prosthesis, as well as condition of the soft tissue. Any disharmony in these factors can lead to the formation of black triangles which are unesthetic.  These unesthetic zones can be corrected by an interdisciplinary approach which includes orthodontic, prosthodontic, periodontic, endodontic branches. The treatment modality that is opted for a particular patient depends on the age of the patient, the biotype of gingiva, the form and condition of the radicular portion of the tooth as well as the interproximal space available. Surgical approach includes the recontouring, reconstructing, preserving of the interdental papilla. Surgical technique includes releasing, reflecting and stabilizing the interdental papilla. The non-surgical approach includes proper aligning of the maligned teeth by fixed orthodontic appliances thus decreasing the crest of bone and contact point distance. Endodontically the gingival black triangles can be treated by the use of composite resin in shades of pink to reproduce gingival contour. Open gingival embrasures can also be corrected with the help of ovate pontics that are easy to design and are more esthetic as compared to the conical pontic. To restore the scalloped architecture of the soft tissue, recontouring of the soft tissue surrounding the restoration followed by placement of ovate pontic can be done which is supported by the adjacent teeth. Open gingival embrasure can be masked with the use of silicones or removable acrylics as a gingival veneer. This type of prosthesis is also helpful in patients who have exposed radicular portion of the tooth because of excessive loss of alveolar bone. This review article discusses about the various etiologic factors accounting to the formation of open gingival embrasures, along with its classification and the various treatment modalities that are taken into consideration.