Black Triangle: Etiology and Treatment Management
Vidya Nursolihati (1), Marie Louisa (1)*

(1) Department of Periodontics, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
* marielouisa[at]trisakti.ac.id

Abstract

Background: Open gingival embrasure or black triangle is a complex esthetic and functional problem because it negatively impacts the smile and facilitates food retention. The etiology is multifactorial and treatment management is achieved by approaching the etiologic factors for successful treatment. Objective: The objective of this review is to describe the etiological factors, classification, and management of black triangle.
Method: Literature reviews with article searches were carried out through PubMed, Scopus, and Google Scholars database with the inclusion criteria articles published in 2014-2024 to identify studies of etiology and treatment management of black triangle. Two examiners performed the eligibility and quality assessment of relevant studies.
Result: Several surgical and nonsurgical techniques have been proposed to treat soft tissue deformities and manage inter-proximal space. The non-surgical approaches include periodontics, orthodontic, prosthetic, and restorative procedures. The surgical approaches are coronally advanced flap and connective tissue graft. A single approach management is not often the best option, especially in extensive loss of periodontal support due to periodontal disease. Such cases need to be handled in a combination of various approaches, both surgical and non-surgical, to obtain predictable results. Conclusion: Black triangle management requires careful evaluation of underlying causes. All etiological factors and treatment alternatives should be discussed with the patient before starting treatment. A multidisciplinary approach is considered necessary to achieve successful clinical outcomes.

Keywords: black triangle, esthetic, surgical, nonsurgical treatment

Topic: Periodontics