Background and Aim : Interdental papilla reconstruction especially at the esthetic zone is among the most difficult periodontal treatments. Papilla deficienciesmay occur following some periodontal surgeries and several techniques, mostly surgical and invasive, have been suggested to correct them. The purpose of this study is to evaluate the clinical application of hyaluronic acid gel for reconstruction of interdental papilla at the esthetic zone .

  Materials and Methods : This experimental before and after study was conducted on 11 patients with 21 interdental papilla deficiencies who met the inclusion criteria. After the induction of local anesthesia, less than 0.2 ml hyaluronic acid gel was injected at the respective areas. This procedure was repeated 3 weeks and 3 months later for all the respective areas. Photographs obtained before the treatment and 3 weeks, 3 months and 6 months after the intervention were assessed by Image J software based on image pixels. Data were extracted and changesin the interdental space at the mentioned time points were statistically analyzed using Repeated Measures ANOVA .

  Results : Application of hyaluronic acid gel for reconstruction of interdental papilla was successful in a 6-month period. In the second follow up, 10% of subjects showed improvement in interdental papilla reconstruction by 50%. In the third follow up (at 6 months) 43% of samples showed 50% improvement or higher. The mentioned differences were statistically significant (P<0.05).

  Conclusion: Application of hyaluronic acid gel is, to some extent, beneficial for reconstruction of interdental papilla at the esthetic zone and is recommended as a non-invasive technique .