scholarly journals Multidisciplinary Approach to Cover an Apex-Exposed Tooth: A Case Report after 6-Year Follow-Up

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Jamila Kissa ◽  
Wafa El Kholti ◽  
Khadija Sekak ◽  
Sihame Chemlali

Introduction. The prognosis for a successful treatment of gingival recessions (GRs) is one of the main criteria for deciding whether or not and how to perform root coverage surgery. The defect-related factors are the most important to predict root coverage outcomes. Thus, severe GR could make the root coverage (RC) challenging especially in cases with advanced interdental clinical attachment loss (ICAL). Case Presentation. This case report demonstrates a challenging management of a deep localized Miller Class III GR with root apex exposure associated with ICAL. After initial therapy, the treatment had consisted of a multidisciplinary approach involving endodontic treatment, periodontal plastic surgery including a laterally positioned flap, and orthodontic treatment. The 6-year follow-up showed improvement in clinical outcomes (recession reduction (RR) and keratinized tissue (KT) augmentation) and a higher patient satisfaction. Conclusions. This case report demonstrates the role of the multidisciplinary approach in the management of deep GRs associated with ICAL. A rational choice of the RC technique was critical to achieve good clinical outcomes.

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Michele Perelli ◽  
Paolo Giacomo Arduino ◽  
Mario Semenza ◽  
Roberto Abundo ◽  
Hector Sarmiento

This case report described a modified bilaminar technique for treating a single gingival recession. Patient presented a gingival recession in a maxillary canine. Tooth was in a buccally prominent position and soft keratinized tissue apical to the recession was reduced but still present. A split-full-split thickness trapezoidal flap was designed. Root’s surface was prepared with curettes. Epithelial-connective tissue graft was harvested from the palate with reduced dimension. After deepithelialization, the graft was placed with a fibrin-fibronectin system at the maximum root coverage level, and the flap coronally advanced and sutured. At 3-year follow-up control, the free gingival margin was still stable at the postsurgery position, with a thicker biotype corresponding to the grafted area, with no probing and a suitable aesthetic result.


2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
P. Stylianou ◽  
N. Soldatos ◽  
E. K. Edmondson ◽  
N. Angelov ◽  
R. Weltman

Recession of the mandibular central incisors is frequently associated with high frenum insertion. Often times, this recession is accompanied by a lack of sufficient amount of keratinized tissue and absence of attached gingiva. In this case report, an ASA I patient presented with Cairo Recession Type 2 (RT2) and a minimal amount of keratinized tissue on the mandibular central incisors and underwent frenuloplasty in the anterior mandible with the use of a conventional scalpel technique due to high frenum attachment. The results demonstrated creeping attachment of 1.0 mm as early as 10 days postoperatively resulting in complete root coverage and closure of the interproximal space between teeth #24 and 25. A second soft tissue surgery was avoided due to complete root coverage which remained stable at the 6-month follow-up appointment.


2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
João B. César Neto ◽  
Marília C. Cavalcanti ◽  
Ricardo T. Sekiguchi ◽  
Claudio M. Pannuti ◽  
Giuseppe A. Romito ◽  
...  

Aim. The aim of this study is to report root coverage outcomes in single deep gingival recessions (GR) following a proposed decision-making algorithm. Materials and Methods. A retrospective, practice-based study included single deep (≥5 mm) Miller Class II and III defects. The step-by-step decision-making algorithm led to a choice among three different flap designs (coronally advanced flap (CAF), double papilla envelope flap (DPE) or modified lateral sliding flap (LSF)) used with a connective tissue graft. Recession depth (RD) at 6 months follow-up and the corresponding root coverage (RC) were the primary outcomes assessed. Results. Sixteen GR defects were included, with baseline RD of 6.7 ± 1.8 mm. Six months postoperatively, RD was significantly reduced to 1.2 ± 0.8 mm (p<0.05). Mean RC was 81.7 ± 13.0%, without significant differences between Miller Class II (87.1 ± 9.2%; n=9) and Class III (74.6 ± 14.5%; n=7) GRs (p=0.07). Postoperatively, keratinized tissue width increase was greater for LSF (3.5 ± 1.1) and DPE (4.2 ± 1.4 mm) than for CAF (1.9 ± 0.9 mm). Conclusions. Following the proposed decision-making algorithm, root coverage outcomes for GR defects ≥5 mm were comparable to outcomes reported for shallow defects. Prospective clinical trials are needed to validate the proposed approach and techniques. Practical Implications. The proposed algorithm allows the clinician to select the appropriate surgical technique for treatment of single deep gingival recessions with good predictability.


2018 ◽  
Vol 22 (2) ◽  
pp. 106-110
Author(s):  
Mustafa Mert Açikgöz ◽  
Ayşem Yurtseven ◽  
Gülsüm Ak

SummaryBackground/Aim: Our aim is to describe multidisciplinary approach to primary tuberculous lymphadenitis with a case report.Case Report: A 6-year-old boy was referred to İstanbul University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery with the symptoms of painless extra-oral abscess and lymphadenopathy. The diagnosis of primary tuberculous lymphadenitis was proved by microbiological culture and ultrasound imaging.Conclusions: Combine tuberculosis treatment should be applied and long term follow up is necessary. Excisional biopsy for tissue diagnosis and bacterial examination with culture should be performed for an early diagnosis as a delay in treatment can lead to devastating consequences.


2012 ◽  
Vol 23 (6) ◽  
pp. 758-763 ◽  
Author(s):  
Rafael Scaf de Molon ◽  
Érica Dorigatti de Avila ◽  
João Antonio Chaves de Souza ◽  
Andressa Vilas Boas Nogueira ◽  
Carolina Chan Cirelli ◽  
...  

One of the main purposes of mucogingival therapy is to obtain full root coverage. Several treatment modalities have been developed, but few techniques can provide complete root coverage in a class III Miller recession. Thus, the aim of this case report is to present a successful clinical case of a Miller class III gingival recession in which complete root coverage was obtained by means of a multidisciplinary approach. A 17-year-old Caucasian female was referred for treatment of a gingival recession on the mandibular left central incisor. The following procedures were planned for root coverage in this case: free gingival graft, orthodontic movement by means of alignment and leveling and coronally advanced flap (CAF). The case has been followed up for 12 years and the patient presents no recession, no abnormal probing depth and no bleeding on probing, with a wide attached gingiva band. A compromised tooth with poor prognosis, which would be indicated for extraction, can be treated by orthodontic movement and periodontal therapy, with possibility of 100% root coverage in some class III recessions.


2019 ◽  
pp. 1-3
Author(s):  
Silvia Ippolito ◽  
Jessica Sabatino ◽  
Davide Inversini ◽  
Matteo Annoni ◽  
Maria Laura Tanda

Introduction: Intrathoracic goiters are associated with compression of nearby structures, triggering severe compressive symptoms. Total thyroidectomy is the gold standard to treat these cases. Case Presentation: A patient with a huge intrathoracic goiter suffering from compressive symptoms underwent a thorough clinical, functional and imaging assessment and underwent total thyroidectomy in an Endocrino-Metabolic surgical referral center; after the surgery she suffered from transient hypocalcaemia but was discharged without major complications and continued periodical endocrinological follow-up. Conclusion: Management of intra-thoracic goiter requires a multidisciplinary approach of a skilled team both pre, during and after surgery to maximize the safety and efficacy of the procedure and reduce or promptly manage surgical or medical complications.


2020 ◽  
Vol 25 (3) ◽  
pp. 3736
Author(s):  
R. N. Akhtereyev ◽  
A. S. Galyavich ◽  
L. V. Baleeva ◽  
Z. M. Galeeva

Aim. To study clinical outcomes in hypertension patients after coronary stenting due to exertional angina.Material and methods. The study included 214 patients with class 3 stable angina and hypertension. All patients underwent coronary angiography followed by elective stenting. Clinical outcomes were assessed on average after 44 months of outpatient follow-up.Results. During the follow-up period, 43% of patients retained class III angina; the decrease in systolic (SBP) and diastolic blood pressure (DBP) was 18and 14-mm Hg, respectively. There were 35 cases of myocardial infarction (MI) in this category of subjects. We revealed that 57% of patients had a progression of angina: from class III to class IV; the decrease in SBP and DBP was 10and 18-mm Hg, respectively. There were 110 cases of MI and 10 cases of acute cerebrovascular accident in these patients.Conclusion. Inadequate control of SBP in patients after stenting due to stable exertional angina leads to a greater number of complications, mainly myocardial infarction.


2021 ◽  
Vol 7 (1) ◽  
pp. 61-66
Author(s):  
Youssef Fahde ◽  
◽  
Davis Mpando ◽  
Mehdi Laghmari ◽  
Houssine Ghannane ◽  
...  

Background and Importance: Transorbitocranial assaults with sharp objects like a knife are rare neuro-ophthalmologic emergencies. However, they can have dramatic functional and life-threatening consequences. Our presentation aims to report the importance of an urgent multidisciplinary approach and to raise awareness among the general population on the importance of preventing violent behavior. Case Presentation: A 33-year-old man was a victim of a knife attack without obvious brain or ophthalmological lesions. The knife entered the medial part of the orbit. Neurological examination was normal, and Computed Tomography (CT) scan showed intracranial trajectory through the orbit to the frontal horn of the lateral ventricle. The knife was extracted without complications. The patient reported spectacular improvement in visual acuity without neurological or oculomotor deficit at long-term follow-up. In this case report, we will discuss the radiological diagnosis and surgical management of transorbital and orbitocranial injuries by foreign body penetration. Conclusion: Urgent multidisciplinary management in orbitocranial trauma by stabbing is mandatory to avoid life-threatening complications and irreversible damages.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
João Carnio ◽  
Anna Tereza Carnio

Introduction. The purpose of this case report was to show the clinical long-term stability of a successful two-step root coverage procedure. A combination of two single techniques was used to treat an isolated deep-wide defect. Case Presentation. A 28-year-old female patient was referred in order to treat a single recession defect at #22. Due to her fear of dental procedures and a poor economic situation, the team developed an alternative solution. They used a modified apically repositioned flap (MARF) to increase the donor area and then a laterally positioned flap (LPF) to treat the root defect. Clinical evaluation at the three-year follow-up revealed complete resolution of the defect, a gain in clinical attachment, excellent esthetic results, and minor morbidity to the patient. Conclusion. The combination of the MARF and the LPF procedures was able to successfully treat a single deep recession defect with some advantages over traditional techniques such as simplicity, ideal color match of tissues, and the absence of palatal donor tissue.


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