The aim of this study was to evaluate the effectiveness of hyaluronic acid (HA) injections used to reduce defects in the gingival papillae in esthetic areas. This randomized study included six patients requiring black triangle treatment in 19 defective papillae. After local anesthesia, less than 0.2 mL of HA was injected 2 to 3 mm into the tip of the deficient papilla in the apical direction. Analysis of the target regions with standardized photographs and 3D intraoral scanning (CEREC 4.5 software with RST files, Dentsply Sirona) was performed at baseline (T0) and at 1 month (T1), 2 months (T2), 3 months (T3), and 4 months (T4) after the initial application of HA. At each time period, the photographic analysis showed no statistically significant differences in linear tissue gain after HA gel application. The 3D analysis showed improvements in the vertical papillae tissue recovery at T3 (0.41 ± 0.21 mm) and T4 (0.38 ± 0.21 mm) when compared to T1 (0.13 ± 0.08 mm; P < .0001). Regarding the reconstruction of the interdental papillae, the general dimensions of the tissue in the black triangle areas showed a significant increase in size percentage at T3 (58% ± 32.9%) compared to T1 (30.41% ± 23.4%; P = .0054). Thus, the application of injectable HA was effective for filling papillae in the esthetic area.
