Gingival fenestration management: A rarefied case entity and literature review

Rajula, M Prem Blaisie; Varatharajan, Kalaivani; Mani, Rekha; Krishnakumar, Shobana

doi:10.4103/jpbs.jpbs_77_20

Cited by 3 publications

(7 citation statements)

References 6 publications

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“…demonstrated increase in tissue thickness with the use of PRF adjunct to CTG in the treatment of recession defects 20 . Although previous case reports 3,5,6,9,10,12 have asserted the use of bone substitutes in isolation or in conjugation with CTG for bone regeneration in the defect, no bone substitute was used in the present cases because the placement of bone substitutes may prolong healing owing to their slow resorption time and may act as a foreign body. Limitation of this report included use of silk sutures.…”

Section: Discussionmentioning

confidence: 82%

“…and Karwa et al. also demonstrated the successful angiogenic potential of PRF when used with bone substitutes in the management of mucosal fenestrations 10,12 . Keceli et al.…”

Section: Discussionmentioning

confidence: 97%

“…13,19 Rajula et al and Karwa et al also demonstrated the successful angiogenic potential of PRF when used with bone substitutes in the management of mucosal fenestrations. 10,12 Keceli et al demonstrated increase in tissue thickness with the use of PRF adjunct to CTG in the treatment of recession defects. 20 Although previous case reports 3,5,6,9,10,12 have asserted the use of bone substitutes in isolation or in conjugation with CTG for bone regeneration in the defect, no bone substitute was used in the present cases because the placement of bone substitutes may prolong healing owing to their slow resorption time and may act as a foreign body.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] Documented techniques for its management include apicectomy, guided tissue regeneration, use of bone substitute alone, or in combination with connective tissue grafts (CTG) and acellular dermal matrix (Table 1 and Supplementary Table S1 in the online Journal of Periodontology). [3][4][5][6][7][8][9][10][11][12] The rationale for employing CTG is that it provides a cellular and vascular base for reattachment of soft tissue and migration of epithelial cells from the edges of the fenestration defect margins. 6 Platelet-rich fibrin (PRF) as an angiogenetic agent has been demonstrated as a healing biomaterial with a great potential of soft and hard tissue regeneration.…”

Section: Introductionmentioning

confidence: 99%

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Management of Isolated Labial Mucosal Fenestration by Endodontic Microsurgery Along With Platelet‐Rich Fibrin and Connective Tissue Graft: A Series of Four Cases

Tewari

Dhiman

Bhagavatheeswaran

et al. 2022

Clin Adv Periodontics

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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.

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Section: Discussionmentioning

confidence: 82%

“…and Karwa et al. also demonstrated the successful angiogenic potential of PRF when used with bone substitutes in the management of mucosal fenestrations 10,12 . Keceli et al.…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Management of Isolated Labial Mucosal Fenestration by Endodontic Microsurgery Along With Platelet‐Rich Fibrin and Connective Tissue Graft: A Series of Four Cases

Tewari

Dhiman

Bhagavatheeswaran

et al. 2022

Clin Adv Periodontics

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“…2 Rajula M et al (2020) successfully managed a case of mucosal fenestration using bioactive glass with platelet rich fibrin and free connective tissue graft. 11 Saravanan et al (2016 ) managed an uncommon presentation of concomitant gingival recession with an isolated mucosal fenestration with an allograft matrix. In the present case connective tissue grafing was done after 6 months after the endodontic retreatment, apicectomy and osseous grafting as there was a significant amount of bone destruction in the initial stage.…”

Section: Discussionmentioning

confidence: 99%

Interdisciplinary management of mucosal fenestration in two stages – A rare case report with one year follow-up

Prathap¹,

Prathap

2022

IJPI

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Gingival fenestrations are relatively rare phenomenon which results from exposure of tooth due to loss of the overlying bone and gingiva. If left untreated such lesions may act as a source of infection by providing a nidus for bacteria. This case report describes one such case of mucosal fenestration that was managed well using an interdisciplinary approach which included endodontic retreatment, periapical surgery with regenerative approach in the first stage. After 6 months second stage surgery was performed using connective tissue graft. At one year follow up, complete closure of the mucosal defect was found with substantial bone regeneration.

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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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Gingival fenestration management: A rarefied case entity and literature review

Cited by 3 publications

References 6 publications

Management of Isolated Labial Mucosal Fenestration by Endodontic Microsurgery Along With Platelet‐Rich Fibrin and Connective Tissue Graft: A Series of Four Cases

Management of Isolated Labial Mucosal Fenestration by Endodontic Microsurgery Along With Platelet‐Rich Fibrin and Connective Tissue Graft: A Series of Four Cases

Interdisciplinary management of mucosal fenestration in two stages – A rare case report with one year follow-up

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

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