An 18-year-old woman presented with enlarged gingivae of 1-year duration with no history of drug consumption or systemic conditions that might explain the enlargement. Biopsy revealed hyperplastic gingival epithelium and a plasma cell-rich inflammatory infiltrate in the subepithelial connective tissue with the presence of scattered multinucleated giant cells. Immunostaining revealed the plasma cells to be positive for IgG4. Serum IgG4 levels were elevated at 3.6 g/L (reference range: 0.049–1.985). These findings led towards the diagnosis of an IgG4-related disease (RD). Other granulomatous conditions were also ruled out via series of investigations. The enlarged tissue was surgically excised. No corticosteroids were administered owing to the localised nature of the manifestations. After 3 months, the gingival size remained unchanged. This case has been reported with a relatively shorter follow-up period because of the rarity of the presentation. IgG4-RD should be considered while diagnosing a patient with gingival enlargement.

No abstract

No abstract

Reattachment of fractured fragments provides the easiest and most aesthetic rehabilitation of fractured teeth, wherever possible. In clinical practice, these cases may have a wide spectrum of presentations, which includes different dehydration times of the fractured fragments, various methods of storage of the fragments, and many reattachment techniques. However, no welldefined protocol exists to guide the reattachment of fractured teeth in such different clinical scenarios. An attempt to develop an algorithm to guide the reattachment of fractured teeth in varied clinical scenarios has been made, using the reports of such cases treated at our center and reviewing the various fragment reattachment techniques mentioned in the literature. This report also describes, in detail, two cases of fractured immature permanent incisors with different extraoral dry time periods (60 days and 18 h) that were successfully treated by reattachment of fractured fragments. Fragment reattachment was found to be a functional and aesthetically acceptable treatment option in restoring the integrity of fractured permanent incisors irrespective of the time elapsed, as the fracture provided the dehydrated fragments was rehydrated before reattachment.