A regenerative approach towards mucosal fenestration closure

Gandi, Padma; Naveen, Anumala; Reddy, A Amarender A.; Chandra, Rampalli Viswa

doi:10.1136/bcr-2013-009604

Cited by 5 publications

(19 citation statements)

References 8 publications

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“…Apical surgery was performed for all cases with or without prior non-surgical root canal (re)treatment, except for 1 as reported by Gandi et al ( 17 ) where a flap was raised to gain access to the apical region, and degranulation and root debridement was performed with no reported root-end resection. Surgical intervention revealed that 9 out of the 24 teeth with mucosal fenestrations involving the root apex were associated with bony dehiscences (37.5%).…”

Section: Resultsmentioning

confidence: 99%

“…Patients with apical fenestrations associated with endodontic pathologies may present with various complaints, signs and symptoms. These include traumatic dental injuries ( 14 , 17 ), aesthetic concerns ( 16 , 28 ), gingival defects or discomfort ( 11 , 16 , 17 , 20 ) and pain, especially on palpation and mastication ( 3 , 12 , 13 ). Patients may develop a habit of rubbing the area of discomfort, which could exacerbate their symptoms ( 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…Following non-surgical treatment of the endodontic infection, apical surgery with root-end resection is often needed to restore a more favourable relationship between the root apex and overlying alveolar bone ( 16 ). When there is a concurrent mucosal fenestration, various treatment options that have been suggested include primary closure ( 2 ), guided tissue regeneration (GTR) ( 17 ) and the use of mucosal grafts ( 10 ). In fact, much variation exists in the surgical management of these lesions.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis and Management of Apical Fenestrations Associated with Endodontic Diseases: A Literature Review

2020

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Apical fenestration describes a window-like opening of the alveolar bone that involves the root apex of the associated tooth. Mucosal fenestration is a similar defect of the overlying mucosa and, when presented with a concomitant apical fenestration, may expose the root apex to the oral environment. A fenestration may arise from physiological and pathological processes. Although its presence does not necessitate treatment per se, these lesions have significant clinical implications when associated with endodontic diseases. Apical fenestrations associated with endodontic infections are relatively uncommon and can easily be overlooked or misdiagnosed. A thorough understanding of these lesions is key for timely diagnosis and successful management. The aim of this study was to review the epidemiology, aetiological factors, characteristics, management methods and potential outcomes of apical fenestrations associated with endodontic diseases. A search of online databases for relevant studies was conducted. With the inclusion of hand searched articles, 20 articles, consisting of case reports and series, were identified, and the key characteristics of each case were summarised. Apical fenestrations were found to be most commonly associated with maxillary teeth and almost always occur on the buccal aspect of the alveolar bone. Clinicians may consider the possibility of an apical fenestration with concurrent endodontic pathology when patients present with non-healing sinus tracts, exposed tooth apices and/or persistent pain after endodontic treatment, particularly on palpation and mastication. Clinical signs and symptoms can vary, hence cone-beam computed tomography is an important tool for diagnosis. The management involves surgically restoring a favourable anatomical configuration of the root apex in relation to the alveolar bony housing and may be combined with guided tissue regeneration and/or grafting procedures. Sloughing, reopening and infection are potential complications. The literature on apical fenestrations associated with endodontic diseases is limited, thus further research is needed to develop evidence-based guidelines for the diagnosis and management of these lesions.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnosis and Management of Apical Fenestrations Associated with Endodontic Diseases: A Literature Review

2020

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“…3 Although the etiology for GFs is unclear, putative factors that have been shown to be associated with GFs include plaque/calculus, cervical enamel projections, trauma, tooth malpositioning, occlusal factors, factitious habits, and iatrogenesis. 4,5 Although some GF lesions can be managed nonsurgically with monitoring and meticulous oral hygiene, surgical correction involving various periodontal plastic surgical procedures is preferred. 2 Successful treatment of GF by connective tissue grafting, 3,4 acellular dermal matrix allograft, 6 and regenerative approaches, 7,8 have been reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, the fenestration lesion may become vulnerable to plaque and calculus accumulation, dentinal hypersensitivity, and compromise the esthetics and periodontal stability of the affected tooth 3 . Although the etiology for GFs is unclear, putative factors that have been shown to be associated with GFs include plaque/calculus, cervical enamel projections, trauma, tooth malpositioning, occlusal factors, factitious habits, and iatrogenesis 4,5 …”

Section: Introductionmentioning

confidence: 99%

Treatment of Gingival Fenestration With a Double Pedicle Flap Approach and Dehydrated Amnion–Chorion Membrane: A Case Report

Bhide

Tenenbaum

2020

Clin Adv Periodontics

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Introduction: Although gingival fenestrations (GFs) occur with relative infrequency, their actual incidence is thought to be much higher. Furthermore, if left untreated, these mucogingival defects can lead to unfavorable sequelae which can compromise the esthetics and stability of the teeth affected. Most GFs require surgical treatment for closure. Previously reported modalities of treatment include connective tissue grafting, acellular dermal matrix allograft, and pedicle flap approaches. This case demonstrates the first documented use of a dehydrated amnion-chorion membrane (dHACM) to treat GF. Case Presentation: A surgical approach involving a double pedicle flap and dHACM with 15 months follow-up is described. Following gentle cleansing of the defect and careful split-thickness elevation of a double pedicle flap, the area of exposure fenestration was covered with dHACM. The overlying flap was then closed carefully to completely cover the dHACM. The case presented shows a successful clinical outcome as characterized by successful closure of the fenestration defect with nice tissue maturation. Conclusion: The technique described in this case report demonstrates that GFs can be successfully treated with a periodontal plastic surgical approach using dHACM with minimal patient discomfort.

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Gingival fenestration defect treated with gingivectomy and gingivoplasty: A case report with an 8‐year follow‐up

Campos

Buischi

Loomer

et al. 2021

Clin Adv Periodontics

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Introduction Gingival fenestration (GF) is scarcely reported in the literature. We present a unique case of GF defect combined with gingivitis and altered passive eruption (APE). Case Presentation An 18‐year‐old female patient with gingivitis, APE, and GF in the mandibular left central incisor presented for periodontal treatment. The gingival lesion was successfully treated with basic periodontal therapy gingivectomy, and gingivoplasty and resulted in an excellent aesthetic long‐term outcome. This case report shows its 8‐year clinical follow‐up. Conclusion There are no earlier reports dealing with the use of gingivoplasty for the treatment of GF, as it is not the usual therapeutic intervention for these defects. Gingivoplasty proved to be effective in treating GF. Why is this case new information? Available literature on gingival fenestration defects does not describe gingivectomy and gingivoplasty as a treatment of choice. Gingivectomy and gingivoplasty proved to be effective in treating gingival fenestration defects. What are the keys to successful management of this case? Proper diagnosis. What are the primary limitations to success in this case? Gingival fenestration has been defined when the overlying gingiva is denuded, exposing the root to the oral cavity. However, in this case report, only the crown was exposed because the patient had altered passive eruption.

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A regenerative approach towards mucosal fenestration closure

Cited by 5 publications

References 8 publications

Diagnosis and Management of Apical Fenestrations Associated with Endodontic Diseases: A Literature Review

Diagnosis and Management of Apical Fenestrations Associated with Endodontic Diseases: A Literature Review

Treatment of Gingival Fenestration With a Double Pedicle Flap Approach and Dehydrated Amnion–Chorion Membrane: A Case Report

Gingival fenestration defect treated with gingivectomy and gingivoplasty: A case report with an 8‐year follow‐up

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