I have a bridge (#7 to #9 teeth) that has some papilary recession between #8 and #9 and, thus, subsequently a black triangle exists. I am wondering if there is a certain technique for fixing this problem area while not removing the bridge? How successful are papilary reconstruction methods?
How to Approach Papillary Gingival Recession Around a Bridge?
Doctor Answers 2
Papillary Gingival Recession Around a Bridge is Determined by the Bone
This is an interesting situation. The gum tissue follows the bone - thus you must have some bone loss between those teeth. Just adding some "gum tissue" over the bone will eventually resorb back. There are, however, a couple ways to improve this - you can remove the bridge and make a new one where you make the contact between the teeth closer to you gum line so you can replace the black triangle with porcelain. A simpler option is to bond composite to the bridge to bring the contact closer to the gum line. This is a less long term and possibly a little less esthetic, but it may serve the purpose for your particular situation and is definitely minimally invasive.
Recession and Bridge
There is free gingival graft surgery that you could look into, but they are not proven to be 100% sucessful. The best option is the combination of a graft with a new bridge.