Comparative Assessment of Interdental Papilla Changes Before and After Orthodontic Treatment: A Retrospective Photographic Analysis

Abstract

Background Interdental papilla integrity plays a crucial role in maintaining periodontal esthetics and functional harmony. Orthodontic treatment may influence interdental soft tissue architecture and contribute to black triangle formation following treatment. Evaluation of papillary changes associated with orthodontic therapy has gained increasing clinical importance in contemporary interdisciplinary dental practice.

Aim To comparatively assess interdental papilla changes before and after orthodontic treatment using retrospective photographic analysis.

Materials and Methods The present retrospective photographic study analyzed 6334 orthodontic patient records retrieved between June 2019 and May 2026. Pre treatment and post debonding intraoral photographs with complete clinical documentation were evaluated using Jemt’s Papilla Index. Parameters assessed included interdental papilla fill, presence of black triangles, arch involved, and association with extraction and non extraction orthodontic therapy. Statistical analysis was performed using SPSS software version 26.0 and p less than 0.05 was considered statistically significant.

Results Female patients constituted 55.0% of the study population. Complete papillary fill corresponding to Jemt’s Score 3 was observed in 73.0% of patients before orthodontic treatment, which reduced to 61.9% following treatment. Clinically evident black triangles were observed in 27.5% of patients post treatment. Interdental papilla loss was predominantly observed in the maxillary anterior region 49.3% compared with the mandibular anterior region 29.6%. Extraction orthodontic therapy demonstrated greater prevalence of papillary loss compared with non extraction treatment. The differences between pre treatment and post treatment papillary scores were statistically significant with p less than 0.05.

Conclusion Orthodontic treatment demonstrated significant association with interdental papilla changes and black triangle formation following treatment, emphasizing the importance of periodontal considerations during orthodontic treatment planning.