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      A comparative evaluation of papillary reconstruction by modified Beagle's technique with the Beagle's surgical technique: A clinical and radiographic study

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          Abstract

          Background:

          To assess and compare the effectiveness of two surgical procedures (Beagle's technique and modified Beagle's technique) for the reconstruction of the lost interproximal dental papilla.

          Materials and Methods:

          Twenty sites were selected based on the selection criteria which included patients within the age group of 20–50 years and the presence of Class I and Class II recession of the papilla in the maxillary anterior region. They were divided randomly into Group A and Group B. Group A sites were treated with modified Beagle's technique, whereas Group B sites were treated by the Beagle's technique. The patients were recalled at 1 week, 1 month, 3 months, and 6 months postsurgery. Parameters including classification of loss of papilla height (Nordland and Tarnow), change in vertical dimension, mesiodistal dimension and area of the papillary defect, and radiographic parameters (papilla height and bone crest-root apex distance) were recorded preoperatively and postoperatively.

          Results:

          At 6-month postsurgery, there was a statistically significant reduction in vertical dimension, mesiodistal dimension, and area of the papilla defect in Group A compared to Group B. At 6-month postsurgery, there was an increase in the height of the papilla in Group A, whereas there was a decrease in the height of the papilla in Group B. At 6-month postsurgery too, there was a reduction in the mean bone crest-root apex distance in both groups.

          Conclusion:

          Thus, the modified Beagle's technique is an easy and effective technique when compared to the Beagle's surgical technique for papilla reconstruction.

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          Most cited references13

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          The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla.

          This study was designed to determine whether the distance from the base of the contact area to the crest of bone could be correlated with the presence or absence of the interproximal papilla in humans. A total of 288 sites in 30 patients were examined. If a space was visible apical to the contact point, then the papilla was deemed missing; if tissue filled the embrasure space, the papilla was considered to be present. The results showed that when the measurement from the contact point to the crest of bone was 5 mm or less, the papilla was present almost 100% of the time. When the distance was 6 mm, the papilla was present 56% of the time, and when the distance was 7 mm or more, the papilla was present 27% of the time or less.
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            A classification system for loss of papillary height.

            A classification system for loss of papillary height is proposed. It uses readily identifiable anatomical landmarks for reference, and sorts the degree of loss into 3 classes. The 3 broad categories allow for a quick descriptive assessment. In addition to the basic classification, it is suggested that additional and incremental description may be included to further define the defects.
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              Black triangle dilemma and its management in esthetic dentistry

              In recent years, clinician and dentist's esthetic demand in dentistry have increased rapidly, driven by an enhanced awareness of beauty and esthetics. The ultimate goal in modern restorative dentistry is to achieve “white” and “pink” esthetics in esthetically important zones. “White esthetics” is the natural dentition or the restoration of dental hard tissues with suitable materials. “Pink esthetics” refers to the surrounding soft-tissues, which includes the interdental papilla and gingiva that can enhance or diminish the esthetic result. Reconstruction of the lost interdental papilla is one of the most challenging and least predictable problems. Restoration and maintenance of these tissues with adequate surgical and prosthetic techniques are a real challenge in modern esthetic dentistry. Treatment of marginal tissue recession, excessive gingival display, deficient ridges, ridge collapse, and esthetic defects around teeth and implants are some of the esthetic problems associated with the interdental papilla that have to be corrected in todays scenario which has been discussed in this review.
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                Author and article information

                Journal
                J Indian Soc Periodontol
                J Indian Soc Periodontol
                JISP
                Journal of Indian Society of Periodontology
                Medknow Publications & Media Pvt Ltd (India )
                0972-124X
                0975-1580
                May-Jun 2017
                : 21
                : 3
                : 218-223
                Affiliations
                [1] Department of Periodontology, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, Maharashtra, India
                Author notes
                Address for correspondence: Dr. Prerna Pravin Chaulkar, Department of Periodontology, A/02, Swati Building, Sector 5, Srishti Complex, Mira Road (E), Thane - 401 107, Maharashtra, India. E-mail: pchaulkar55@ 123456gmail.com
                Article
                JISP-21-218
                10.4103/jisp.jisp_166_17
                5803878
                29440789
                b10d1a92-1ca0-4f5e-a68d-80cce1346885
                Copyright: © 2018 Indian Society of Periodontology

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 23 July 2017
                : 28 September 2017
                Categories
                Original Article

                Dentistry
                beagle's technique,modified beagle's technique,papilla height
                Dentistry
                beagle's technique, modified beagle's technique, papilla height

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