Regenerative treatment for mucosal fenestration in the posterior maxilla.

| Posted in: Science

Journal name: Journal of Indian Society of Periodontology
Original article title: A regenerative approach using xenograft and PRF membrane in the management of muscosal fenestration in posterior maxilla – A rare case report
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:

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Author:

Swapnil Sanjay Karwa, Lalitha Basappa Shiggaon, Alka Sanjay Waghmare, Mayur Ashok Dhavan


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: A regenerative approach using xenograft and PRF membrane in the management of muscosal fenestration in posterior maxilla – A rare case report

Year: 2021 | Doi: 10.4103/jisp.jisp_224

Copyright (license): CC BY-NC-SA


Summary of article contents:

Introduction

Mucosal fenestration is a rare dental condition characterized by the exposure of a tooth's apex in the oral cavity, resulting from the degradation of the surrounding bone and mucosa. This condition can lead to plaque accumulation, which can negatively impact the tooth's prognosis if not addressed. While the literature includes discussions about mucosal fenestrations primarily in the anterior region of the maxilla, evidence specific to posterior regions is limited. This case report highlights the surgical management of mucosal fenestrations in the posterior maxilla utilizing a regenerative periodontal flap approach with xenograft material (Osseograft) and a platelet-rich fibrin (PRF) membrane.

Regenerative Therapy for Mucosal Fenestration

The case presented involves a 27-year-old male patient with mucosal fenestration affecting the maxillary first molar. The treatment plan focused on performing root canal therapy, followed by an apicoectomy, and the application of regenerative techniques to restore both the bone and soft tissue. After thorough debridement of infected tissue and sealing of root canals with mineral trioxide aggregate (MTA), a xenogenic bone graft was introduced to the defect, subsequently covered with a PRF membrane. The PRF, derived from the patient’s own blood, plays a crucial role in promoting healing through the release of various growth factors. The treatment resulted in successful regeneration of the affected area and improvement over a follow-up period, demonstrating the effectiveness of this regenerative approach.

Conclusion

Mucosal fenestration, although rare, can have significant implications for dental health if untreated. This case successfully illustrates that mucosal fenestration in the posterior region can be effectively managed through a combination of surgical intervention and regenerative therapy. By utilizing approaches like apicoectomy alongside bone grafting and PRF application, clinicians can enhance the healing process and improve the long-term prognosis of affected teeth. The findings emphasize the importance of tailored surgical strategies in managing dental conditions that compromise tooth integrity and health.

FAQ section (important questions/answers):

What is mucosal fenestration and its clinical significance?

Mucosal fenestration is a rare condition where the apex of a tooth is exposed due to bone and mucosa breakdown. If untreated, it can lead to plaque accumulation, inflammation, and potential tooth loss.

What causes mucosal fenestration in teeth?

The etiology of mucosal fenestration includes occlusal trauma, root-bone angulation, inadequate soft tissue thickness, and pulpal diseases, among other factors that compromise the surrounding bone and tissue integrity.

How was the case of mucosal fenestration managed?

Treatment involved root canal therapy, periodontal flap surgery, apicoectomy, and regenerative procedures using xenograft and platelet-rich fibrin (PRF) membrane to promote healing and tissue regeneration.

What are the outcomes of using PRF in treatment?

The use of PRF has shown to accelerate healing, enhance tissue regeneration, and lead to complete resolution of mucosal fenestration, along with favorable clinical and radiographic outcomes.

What postoperative care is recommended after mucosal fenestration treatment?

Postoperative care includes maintaining oral hygiene, using prescribed antiseptics, attending follow-up appointments, and managing any symptoms with medications like antibiotics and analgesics as advised by the dentist.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Regenerative treatment for mucosal fenestration in the posterior maxilla.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
In the context of research articles, 'Table' often refers to a systematic organization of data or information displayed in rows and columns. This helps readers easily access and comprehend complex information, facilitating analysis. Tables are commonly used to summarize study findings, compare results across different parameters, or present demographic data succinctly.

2) Rich (Rch):
The term 'Rich' can refer to a variety of contexts in scientific discussions. In this case, it often denotes high nutrient content, particularly relevant to the healing properties of materials like Platelet-Rich Fibrin (PRF). Rich, contextually, indicates an abundance of essential components that can foster tissue regeneration and healing.

3) Surface:
The word 'Surface' is particularly significant in dental and medical contexts, as it pertains to the outer layer of a structure. In treatments involving mucosal fenestrations, the surface of dental roots or graft materials directly influences healing and integration with surrounding tissues, thus impacting the success of regenerative procedures.

4) Accumulation (Accumulating, Accumulate):
Accumulation generally refers to the buildup of substances or materials over time. In dentistry, plaque accumulation on root surfaces can lead to severe complications such as inflammation and infection. Managing accumulation is critical in preventive measures and treatment outcomes for periodontal and endodontic conditions.

5) Inflammation:
Inflammation is a biological response to tissue injury or infection that is significant in healing processes. In dental health, it often indicates the presence of infection due to factors like mucosal fenestration or root exposure. Understanding inflammation helps guide treatment decisions to restore health and prevent complications.

6) Surrounding:
The term 'Surrounding' highlights the importance of adjacent tissues and structures in dental health and treatment outcomes. In the case report, surrounding tissues such as gums and bone are critical in analyzing healing, regeneration, and the overall prognosis for the affected tooth.

7) Relative:
Relative signifies a comparison or relationship between two or more variables or conditions. In clinical scenarios, understanding relative factors—like risk levels for certain procedures or conditions—can inform treatment strategies. It aids clinicians in tailoring management plans based on individual patient circumstances for optimal outcomes.

8) Incision:
An incision is a cut made during surgical procedures to access underlying tissues. In the case of mucosal fenestration, appropriate incision techniques are essential for successful flap reflection and exposure of affected areas. Proper incision practices can minimize complications and promote effective healing after surgery.

9) Hygiene (Hygienic):
Hygiene refers to practices that maintain health and prevent disease, particularly oral hygiene in dental contexts. Effective hygiene practices are crucial for preventing plaque accumulation and inflammation, as seen in mucosal fenestration cases. Patient education on hygiene contributes significantly to treatment outcomes and long-term dental health.

10) Pain:
Pain is a critical symptom that can guide diagnosis and treatment in dentistry. It often indicates underlying issues such as infection or irritation. The management of pain is fundamental in clinical practice, influencing patient comfort and cooperation during procedures and recovery.

11) Transformation (Transform, Transforming):
In medical contexts, 'Transforming' often refers to changing the state or condition of tissues, typically in a healing or regenerative context. Transforming growth factors play a significant role in tissue regeneration processes, making this term relevant in discussions about the regenerative capabilities of materials used in dental surgeries.

12) Discussion:
Discussion serves as a critical analysis section in research papers, synthesizing findings, contextual comparisons, and implications. It involves presenting interpretations concerning observed results and guiding the reader through broader implications or future directions for research in associated fields, such as dental health care.

13) Collecting:
Collecting involves gathering samples or data, crucial in both clinical settings and research contexts. In the case report, the process of collecting blood is vital for producing Platelet-Rich Fibrin (PRF) membranes. Effective collection techniques can affect the quality and reliability of subsequent treatment outcomes.

14) Reflecting:
Reflecting pertains to the surgical technique of repositioning tissues, such as mucoperiosteal flaps, during procedures. In the management of dental conditions, reflecting tissues properly ensures adequate exposure for treatment, aids in healing, and can impact the overall success of reparative and regenerative efforts.

15) Detachment:
Detachment, in a medical context, refers to the separation of tissues or structures, potentially leading to complications. In terms of dental health, detachment can occur in cementum layers or surrounding tissues during surgical procedures, impacting healing efficacy and the potential for infection or other complications.

16) Antibiotic (Antibacterial):
Antibiotics are critical medications used to fight bacterial infections. In dental procedures, they can help prevent or treat infections, particularly in cases involving compromised areas, such as mucosal fenestrations. Understanding antibiotic use is essential in promoting healing and managing potential complications.

17) Composite:
Composite refers to a material made from two or more constituent materials, often used in dental restorations. Composite materials are designed for aesthetic and functional purposes, and their application is significant in restoring teeth after procedures like root canal treatment, promoting both health and appearance.

18) Dressing:
Dressing refers to the protective covering applied to a wound or surgical site. In dental practice, the dressing aids in protecting surgical flaps and promoting healing. Proper application and timing of dressings are essential for minimizing infection risks and maximizing recovery following surgical interventions.

19) Disease:
Disease refers to a pathological condition of a bodily part, an organism, or system resulting from various causes. Understanding disease processes is crucial in dentistry for diagnosis, treatment planning, and patient education, particularly in conditions like apical periodontitis or mucosal fenestrations, which affect tooth health.

20) Mineral:
Mineral signifies inorganic compounds that are crucial for various bodily functions. In dental health, minerals like calcium are essential for maintaining bone density and dental structure. They play a vital role in tooth repair and regeneration, influencing the success of treatments aimed at restoring dental health.

21) Filling (Filled):
Filled involves the action of making an empty space full, particularly relevant in dental contexts related to restorative procedures. Ensuring that cavities or root canals in teeth are filled adequately with appropriate materials is critical for preventing future issues, such as infection or structural failure.

22) Repair:
Repair denotes the process of restoring integrity to damaged tissues or structures, significant in both medical and dental contexts. Effective repair techniques are essential for restoring function and aesthetics in dentistry, influencing outcomes in procedures such as root canals and regenerative therapies.

23) Visit:
Visit refers to a scheduled consultation between a patient and a healthcare provider. Regular dental visits are crucial for monitoring health, assessing and managing treatments, and ensuring ongoing maintenance of dental hygiene, ultimately leading to better oral health outcomes for patients.

24) Blood:
Blood is a vital fluid that carries oxygen and nutrients throughout the body. In dental procedures, blood collection is essential for regenerative therapies, such as producing PRF. The quality and characteristics of blood impact healing capabilities, inflammation, and overall outcomes in surgical interventions.

25) Food:
Food refers to substances consumed for nutritional support. In dentistry, dietary habits can significantly influence oral health, affecting conditions like plaque accumulation and periodontal disease. Patient education on nutrition can aid in preventing future dental issues and contribute to overall health and well-being.

26) Gold (Golden):
Gold refers to a precious metal often utilized in dental restorations due to its biocompatibility and durability. Gold fillings and crowns are commonly chosen for their aesthetic qualities and resistance to corrosion. Its relevance lies in providing restorative solutions that enhance both function and appearance in dentistry.

27) Male:
Male denotes a gender classification generally associated with biological distinctions. In medical studies, gender can influence health outcomes and treatment responses. The relevance of 'male' in clinical reports is critical for understanding demographic variations in conditions, responses to treatment, and overall health implications.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Regenerative treatment for mucosal fenestration in the posterior maxilla.’. Further sources in the context of Science might help you critically compare this page with similair documents:

Clinical examination, Surgical treatment, Treatment plan, Oral hygiene maintenance, Root canal therapy, Bone loss, Growth factor, Platelet-rich-fibrin, Periodontal flap surgery, Regenerative therapy, Bacterial biofilm.

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