Enamel matrix derivatives are a class of xenogeneic proteins that have shown considerable clinical and histological improvements in periodontal wound healing. The proteins array is currently undetermined in its entirety, however it has been extensively studied in periodontal regeneration. It has resulted in true periodontal regeneration, with the formation of all periodontal structures resembling the developmental stages of periodontal structures. The biological cues in this chemical have received FDA approval for human usage in periodontal practise. It is employed in a variety of surgical treatments, including root covering surgery, periodontal regenerative surgery, bone regeneration, ridge augmentation techniques, and has gained popularity in difficult implant regenerative procedures. The creation of this sophisticated biomolecule-based protein concentration is a godsend to periodontists.
BackgroundA proper case selection and decision making is essential for management of multiple marginal tissue recessions (MTR) using a conventional or bilaminar approach. Coronally advanced flap (CAF) is one of the commonly used methods for management of MTR. CAF has been advocated in combination with soft tissue grafts as bilaminar technique, which had showed significant success in terms of root coverage.Methods and ResultsAim of this case series was to retrospectively evaluate Zucchelli's modification of envelope CAF (eCAF) and site‐specific bilaminar methods using Acellular Dermal Matrix (ADM) and Connective Tissue Graft (CTG) for management of MTR. A total of 15 subjects (five subjects/25 sites per technique, total number of sites = 75) who were managed by three different techniques with 12 months postoperative records were retrospectively evaluated. All patients showed significant clinical improvement in root coverage outcomes when compared to baseline. Mean root coverage achieved at 3 months (90%), 6 months (95%) and 12 months (95%) postoperatively did not reveal significant difference between three methods. Complete root coverage was observed in 86.6% of eCAF cases and in 86.6% and 95% of ADM/CTG with eCAF, respectively. There was an increase in width of keratinised tissue, both individually and collectively across all of the groups.ConclusionClinical outcomes suggested that bilaminar techniques should be used only in specific cases. Predictable results can be obtained without the use of a soft tissue graft or substitute if a careful treatment plan for technique selection is developed on an individual case‐by‐case basis.Key pointsWhy is this case new information?
Comparison of site‐specific bilaminar modalities with modified coronally advanced flap alone
What are the keys to successful management of such cases?
Flap advancement and mobilisation
Flap passivity
What are the primary limitations to success in such cases?
Case selection
Flap tension
Soft tissue phenotype
Thickness of graft
Operator skills
Eyes don’t see what mind does not know. It is important for a clinician to refresh his knowledge frequently to recognize some of the conditions that one may come across rarely no matter how insignificant the condition may seem. Especially in a dental outpatient department setting, individuals may complain of varied symptoms which the clinician, often tends to correlate to one of the oral diseases. We present a case of Eagle's syndrome with vague clinical presentation which could have easily gone undiagnosed if not for the application of simple diagnostic procedures and aids like Orthopantamogram (OPG).
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