The dilemma of the open gingival embrasure between maxillary central incisors

Abstract

Aim: The aim of this report is to present the etiology, diagnosis, and treatment planning strategy in the presence of an open gingival embrasure between the maxillary central incisors.

Background: The open gingival embrasure or "black triangle" is a visible triangular space in the cervical region of the maxillary incisors. It appears when the gingival papilla does not completely fill in the interdental space. The space may occur due to: (1) disease or surgery with periodontal attachment loss resulting in gingival recession; (2) severely malaligned maxillary incisors; (3) divergent roots; or (4) triangular-shaped crowns associated with or without periodontal problems and alveolar bone resorptions.

Report: The post-treatment prevalence in adult orthodontic patients is estimated to be around 40% compromising the esthetic result.

Conclusion: Several methods of managing patients with open gingival embrasure exist, but the interdisciplinary aspects of treatment must be emphasized to achieve the best possible result. The orthodontist can play a significant role in helping to manage these cases.

Clinical significance: Various treatment strategies are available to treat cases of an undesirable black triangle and are dependent on the etiology of the condition.