Although titanium is considered as the biocompatible material and widely used in medical and dental fields, the clinical application of this material is still a critical issue due to the possible adverse host response. Very few case reports related with titanium-based hypersensitivity reactions with dental implants proved the existence of titanium allergy. The present case report describes 56-year-old male showing allergic symptoms after 1 week of dental implant placement with no perioral or facial signs, but eczema was shown on the distant body parts, and the complete remission was attained after removing the dental implant.

Despite the high success rates and stability of dental implants, failures do occur. The most important etiological factors for early implant failure are surgical trauma together with bone volume and quality, while etiology of late failures is more controversial. Occlusal overload and peri-implantitis could be associated with late failures. Suboptimal implant design and improper prosthetics also play an important role in implant complications and failure. Early detection and treatment of initial progressive bone loss around dental implants by mechanical debridement with plastic/titanium/gold-plated instruments, antimicrobial therapy, and regenerative therapy are the keys for the revival of early failing implants. The aim of this paper is to describe different causes of failure in detail and treatment modalities to deal with dental implant failure.

Introduction The purpose of this case report is to present endodontic and periodontal management of mucosal fenestrations with exposed root apices. The treatment protocol in present cases includes a combination of regenerative therapy using platelet‐rich fibrin (PRF) with connective tissue graft (CTG) and endodontic microsurgery. Pre‐existing condition of these teeth exhibits apical lesion with prominent root position and complete buccal bone dehiscence/fenestration presents a true challenge to successful outcome. Case Presentation Four patients having concomitant mucosal fenestrations with an apical lesion and complete denudation/fenestration of the buccal plate were treated with root canal treatment and then by endodontic microsurgery. After the root‐end resection and retrograde filling, PRF was placed in the bone defect maintaining intimate contact with the bone surface. CTG was harvested from the palate, placed over the PRF, and beneath the flap corresponding to the mucosal fenestration defect, and sutured with the flap to ensure a secured position. The flap was then repositioned and sutured. All patients showed the complete coverage of the mucosal fenestration with no post‐operative complications and were followed up to 2–5 years. Conclusion Peri‐radicular endodontic microsurgery and CTG along with PRF may be used as a predictable treatment option to manage the mucosal fenestrations in such challenging cases.

Introduction: Gingival recession (GR) is the location of marginal periodontal tissues apical to the cemento-enamel junction. Treatment of GR can be done by free gingival graft, laterally positioned pedicle flap, coronally displaced flap, and subepithelial connective tissue graft, semilunar coronally repositioned flap (SCRF). The purpose of this case report is to highlight the simplicity of carrying out SCRP procedure and its long-term benefits in case of maxillary gingival recession. Methods: Three systemically healthy patients aged 35-43 years reported with chief complaint of unesthetic appearance of teeth. Following full mouth scaling and root planning, patients were scheduled for root coverage procedure. SCRF was performed under local anaesthesia and postoperative instructions were given. Patients were asked to record VAS pain score and number of analgesics consumed for 3 days and recalled on 3rd, 10th day, 1, 3, 6 months and 1 year postoperatively. Results: All patients showed complete root coverage for 1 year postoperatively. VAS score showed mild pain for 3 days postoperatively. Conclusion: Semilunar coronally advanced flap is an effective, simple and highly acceptable periodontal plastic procedure.

Introduction: Lateral window sinus augmentation is done to augment the vertical sinus height for implant placement. Putty alloplasts have been used due to their longer resorption time and provide resistance to implant insertion. Although, widely used, the stability and bone loss around implants placed simultaneously following sinus augmentation with putty bone graft has not been evaluated. Aim: To evaluate the effect of putty alloplastic bone substitute on implant stability. Materials and Methods: This prospective interventional study was conducted in the Outpatient Department (OPD) of Oral and Maxillofacial surgery at SGT Dental College and Research Institute, Gurugram, Haryana, India. The duration of the study was two years and 11 months, from December 2014-November 2016. A total of 15 implants were placed simultaneously after lateral window sinus augmentation. Primary implant stablity measurements were done using Resonance Frequency Analysis (RFA). Vertical Bone Height (VBH), Maximum Insertion Torque (MIT) and Crestal Bone Loss (CBL) were measured till six months of follow-up. The data was analysed using standard statistical analyses with Shapiro-Wilk-test, Wilcoxon signed-rank test and Spearman’s correlation co-efficient. Results: The mean age of the study participants was 58±3.04 years. A total of 15 implants were placed in 12 patients. Adequate primary stability was achieved with MIT >36 N/cm2 in 9/15 patients whereas, in 6/15 patients the MIT was ≤36 N/cm2 . The implants showed 100% survival rate. Postoperative bone gain obtained was in the range of 7.89 mm to 11.9 mm, with a mean of 9.92 mm. Acceptable levels of implant stability were obtained after six months. Conclusion: Within the limitations of the study, it can be concluded that, putty bone alloplast can serve as an adequate bone substitute in simultaneous implant placement after lateral window sinus augmentation and help in achieving stability.