Development of eggshell membrane as an alternative for black triangle reconstruction following orthodontic tooth movement

Improper tissue alterations can occur following orthodontic treatment. One of such alterations is the opening of the interdental papilla, the so-called "black triangle" (BT), which can affect smile appearance and lead to functional problems. Use of hyaluronic acid (HA) to treat BT is an innovation that has significant results. The newest sources of HA can be extracted from the chicken eggshell membrane (ESM), which might have the potential to treat BT as effectively as commercial HA. The aim of this study was to investigate the effectiveness of ESM containing HA in treating BT. Thin-layer chromatography (TLC) was used to detect HA isolated from ESM, while Fourier-transform infrared spectroscopy (FTIR) analysis was performed to confirm the formation of HA. A total of 18 Cavia cobaya were equally divided into two groups, treatment (10% HA injection) and control (phosphate-buffered saline), to confirm the efficacy of the materials in vivo. Parameters obtained from clinical observations of the differences between ligature-papilla distances (LPD) and socket-papilla distances (SPD) measurement was compared with independent t-tests. The FTIR analysis showed that HA was successfully identified from the ESM samples. This was indicated by the adsorption –OH band at 3419 cm⁻¹, the–COOH band at 1634 cm⁻¹, and the C–O–C saccharide unit at 1049 cm⁻¹. Moreover, HA was also detected from ESM under UV light at 254 nm using thin layer chromatography (TLC) analysis. Local injection of 10% HA induced an augmentation effect of the interdental papilla compared to that in the control group (P<.05). The results of this study reveal that ESM containing HA has the potential effect to regenerate the interdental papilla construction after orthodontic tooth movement. (paper)