Management and Histobacteriological Findings of Mucosal Fenestration: A Report of 2 Cases

Ricucci, Domenico; Siqueira, José F.; Loghin, Simona; Grosso, Antonio Andrea; Valois, Érica Martins; Leal, Alex Sandro Mendonça

doi:10.1016/j.joen.2018.07.014

Cited by 8 publications

(13 citation statements)

References 16 publications

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“…From Ricucci et al (2018a) – ‘During surgery, the root apices were resected to within the alveolus and the fenestrated area covered by the flap. Specimens consisting of the root apex and surrounding soft tissues were subjected to histopathological and histobacteriological analyses.…”

Section: The Price 2020 Explanation and Elaboration Documentmentioning

confidence: 99%

PRICE 2020 guidelines for reporting case reports in Endodontics: explanation and elaboration

et al. 2020

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Case reports play a key role in showcasing new, unusual or rare disease(s), and the impact of newer therapeutic approaches or interventions. The Preferred Reporting Items for Case reports in Endodontics (PRICE) 2020 guidelines are being introduced exclusively for Endodontics by adapting and integrating the CAse REport (CARE) guidelines and Clinical and Laboratory Images in Publications principles. The PRICE 2020 guidelines have been developed to help authors improve the completeness, accuracy and transparency of case reports in Endodontics and thus enhance the standard of manuscripts submitted for publication. The aim of this document is to provide a comprehensive explanation for each item in the PRICE 2020 checklist along with examples from the literature that demonstrate compliance with these guidelines. This information will highlight the importance of each item and provide practical examples to help authors understand the necessity of providing comprehensive information when preparing case reports. A link to this PRICE 2020 explanation and elaboration document is available on the Preferred Reporting Items for study Designs in Endodontology website at http://www.pride-endodonticguidelines.org.

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Section: The Price 2020 Explanation and Elaboration Documentmentioning

confidence: 99%

PRICE 2020 guidelines for reporting case reports in Endodontics: explanation and elaboration

et al. 2020

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“…Mucosal fenestrations have been reported more frequently on the labial aspect of maxillary or mandibular anterior teeth. [1][2][3][4][5][6] Absence of or thin buccal cortical plate and tooth malposition with pronounced labial inclination of root apex are the common predisposing factors for this pathological condition. Other possible etiological factors include chronic periapical inflammation with bone destruction, trauma, orthodontic tooth movement, root resorption, or developmental anomalies.…”

Section: Introductionmentioning

confidence: 99%

“…Other possible etiological factors include chronic periapical inflammation with bone destruction, trauma, orthodontic tooth movement, root resorption, or developmental anomalies. 4,6,7 Management of mucosal fenestration defects usually require a combined therapy (endodontic treatment and periodontal surgeries) to achieve predictable treatment outcomes. Reported treatments include endodontic therapy with root-end resection 2,4,8,9 root surface debridement with chlorhexidine mouth-rinsing 9,10 excisions of the epithelial margin with primary closure of the mucosal defect 2,4,11 pedicle flap surgery 8,9 autologous soft tissue graft 5,7,12 or substitute 13,14 and/or regenerative osseous surgery.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, mucosal, apical, or gingivo‐osseous pathologic fenestrations are relatively uncommon and results in the exposure of the root surface to oral environment. Mucosal fenestrations have been reported more frequently on the labial aspect of maxillary or mandibular anterior teeth 1–6 . Absence of or thin buccal cortical plate and tooth malposition with pronounced labial inclination of root apex are the common predisposing factors for this pathological condition.…”

Section: Introductionmentioning

confidence: 99%

“…4,6,7 Management of mucosal fenestration defects usually require a combined therapy (endodontic treatment and periodontal surgeries) to achieve predictable treatment outcomes. Reported treatments include endodontic therapy with root-end resection 2,4,8,9 root surface debridement with chlorhexidine mouth-rinsing 9,10 excisions of the epithelial margin with primary closure of the mucosal defect 2,4,11 pedicle flap surgery 8,9 autologous soft tissue graft 5,7,12 or substitute 13,14 and/or regenerative osseous surgery. 1,6,7 Although in past few years, use of autologous platelet concentrates such as platelet rich fibrin (PRF) alone in bone regeneration 15 and minimally invasive surgical techniques has gained wide acceptance and popularity among clinicians in reconstructive surgery, their application in management of mucosal fenestration has never been reported.…”

Section: Introductionmentioning

confidence: 99%

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Successful management of a large mucosal fenestration at 18‐months follow‐up

Yadav

Gupta

Chawla

et al. 2021

J Esthet Restor Dent

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Objectives Mucosal fenestrations are infrequent and often challenging to treat depending on the extent of soft and hard tissue destruction. This article presents the successful management of a relatively larger mucosal fenestration associated with complete absence of buccal bone plate in a mandibular incisor secondary to trauma‐induced periapical pathosis. Clinical considerations After non‐surgical endodontic therapy, surgery was performed for debridement of the osseous defect, root resection/shaping, connective tissue graft (CTG) placement on the affected root surface and platelet rich fibrin (PRF) in periapical osseous defect rather than use of bone graft and/or barrier membrane. Healing was uneventful, however, a small mucosal defect remained at 2 weeks follow‐up. After 3 months of primary surgery, a corrective surgery was performed utilizing an “incision‐free” approach i.e. tunnel technique with CTG in contrast to the contemporary flap approach. At 18 months follow‐up, complete closure of the mucosal defect with a thick gingival biotype, normal sulcus depth, and good esthetic outcome were achieved. No recurrence and any clinical signs of infection or inflammation were observed. Conclusions Based on the outcomes of present case, an early intervention utilizing the minimally invasive surgical therapy and autologous biomaterials may be considered a viable approach to treat such complex lesions. Clinical significance Endodontic therapy in combination with PRF and CTG appears to provide successful outcomes in treatment of a large mucosal fenestration with periapical osseous defect.

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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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Management and Histobacteriological Findings of Mucosal Fenestration: A Report of 2 Cases

Cited by 8 publications

References 16 publications

PRICE 2020 guidelines for reporting case reports in Endodontics: explanation and elaboration

PRICE 2020 guidelines for reporting case reports in Endodontics: explanation and elaboration

Successful management of a large mucosal fenestration at 18‐months follow‐up

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

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