Injectable Platelet-Rich Fibrin and Microneedling For Papillae Reconstruction In Esthetic Zone (A Case Series )

The patients diagnosed with black triangles according to Norland classification system for loss of papillary height will be selected. Each patient will receive a proper knowledge of the study protocols along with full-mouth scaling and root planing (SRP) using ultrasonic and hand instruments and will be given personalized oral hygiene instructions. After oral prophylaxis and baseline measurements of insufficient interdental papilla the treatment will be MN and iPRF. First, MN will be done in the required area with insulin syringe gauge 30,The interdental papilla will vertically and horizontally measured in mm. By establishing a ratio and proportion, the number of microchannels in the region to be treated will calculated to be 250 microchannels per square cm. Then, a venous blood sample will be taken for each patient using a 10-ml injector into i-PRF tube containing no anticoagulant and centrifuged at room temperature for 3 min at 700 rpm (60 g force). The 30-gauge dental injector needles will be used for injection of i-PRF. The needle will be inserted at 45° angle, 2-3-mm apical to the involved papilla and all surrounding areas will receive iPRF. Each involved papilla will be injected with an amount till blanching is visible . This method will be repeated for 4 times at 10 days intervals consecutively. The final clinical photographs and measurements will recorded 3 and 6 months of last dose administered . After the intervention, patients will receive oral hygiene instructions that include the roll technique when brushing without the use of floss and toothpick during the study period to minimize trauma to the treated site .