Sudden tooth loss in the esthetic zone of the maxillary or mandibular anterior region can be due to trauma, periodontal disease, or endodontic failure. The treatment options for replacing the missing tooth can vary between removable prosthesis, tooth-supported prosthesis, and implant-supported prosthesis. Irrespective of the final treatment, the first line of management would be to provisionally restore the patient's esthetic appearance at the earliest, while functionally stabilizing the compromised arch. Using the patient's own natural tooth as a pontic offers the benefits of being the right size, shape, and color and provides exact repositioning in its original intraoral three-dimensional position. Additionally, using the patient's platelet concentrate (platelet rich fibrin) facilitates early wound healing and preservation of alveolar ridge shape following tooth extraction. The abutment teeth can also be preserved with minimal or no preparation, thus keeping the technique reversible, and can be completed at the chair side thereby avoiding laboratory costs. This helps the patient better tolerate the effect of tooth loss psychologically. The article describes a successful, immediate, and viable technique for rehabilitation of three different patients requiring replacement of a single periodontally compromised tooth in an esthetic region.
An aberrant frenum causes aesthetic and functional problems such as gingival recession both due to interference in the plaque control or due to a muscle pull, can cause midline diastema, which presents an aesthetic problem, compromise the orthodontic treatment and may lead to recurrence after the treatment. Loss of sulcus depth and ankyloglossia also lead to problems with speech articulation and swallowing. The management of such an aberrant frenum is accomplished by performing a frenectomy.The present case report shows the removal of the abnormal maxillary labial frenum in a 25-year-old female patient through the Z-plasty technique.
Localized gingival enlargement is often associated with specific systemic medication, abscess formation, trauma or reactive lesions. Scant literature is available reporting exophytic lesion of gingiva due the metastatic malignant tumours. Here we present case of a 60 year old male which highlights that metastases should influence the clinician's differential diagnosis of oral mucosal lesions. In about 31% of the cases, oral metastasis was found to be the first indication of an occult malignancy at a distant site. However its clinical presentation is variable which may create diagnostic dilemma or may lead to erroneous diagnosis. Furthermore, the gingiva, a tissue prone to inflammation may serve as a pre-metastatic niche for the attraction of circulating malignant cells. This infrequently occurring case report of well differentiated metastatic adenocarcinoma accentuates the need of good interdisciplinary teamwork between the clinician and the pathologist.
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