Correlation between Tooth Position Parameters and Apical Fenestration: A Cone-Beam Computed Tomography Study.

This study aimed to assess the relationship between apical fenestration-a defect in the alveolar bone involving the root apex-and tooth position in all tooth groups, excluding the third molars, utilizing cone-beam computed tomography (CBCT) images. A total of 800 CBCT scans (400 maxillary and 400 mandibular) from patients undergoing various treatments were examined by a single professional (radiologist and endodontist). Statistical analyses, including the chi-square test or Fisher's exact test, were conducted using R software 2.7.3 (R Foundation, Vienna, Austria). Results indicated a significant association (p ≤ 0.05) between apical fenestration and tooth position. In the upper teeth, apical fenestrations were notably present in the mesio-buccal (17.17%) and disto-buccal (11.07%) roots of the first molars. Conversely, apical fenestrations in the lower teeth were relatively less frequent. The study revealed a negative correlation between apical fenestration and mesial inclination, rotation, and extrusion in the upper teeth. However, a positive correlation was observed between apical fenestration and lingual inclination in the upper teeth. In conclusion, this study illuminates the distribution of apical fenestration and its correlation with tooth positions, offering insights into factors influencing this defect in dental anatomy. The findings enhance our understanding of nuanced relationships between tooth position and apical fenestration in the upper and lower dental arches.

Understanding root fenestration: A systematic scoping review of prevalence and clinical factors.

The aim of this systematic scoping review is to explore the literature on root fenestration prevalence and its possible etiologic, aggravating and predisposing clinical factors. A systematic search was conducted in 5 electronic databases, by two independent reviewers, without any language and date restrictions. Forty-six full-text records were included in the study, out of which 27 were used for prevalence analysis and 42 for clinical factor analysis. The results suggest that the literature is heterogenous, with major differences in the study protocols and results' presentation, providing limited information regarding root fenestration prevalence and possible racial distribution patterns. Further documentation is also required regarding clinical parameters that may affect root fenestration's presence and severity. Despite their few limitations, retrospective cone beam computed tomography studies with high-resolution protocols, as well as open flap studies for direct observation of possible root fenestration sites, seem the most reliable methods to better comprehend its presence and possible distribution patterns.

Management of Root Fenestration Using Buccal Decortication and Guided Tissue Regeneration: A Case Report and 3-dimensional Analysis.

The management of patients with apical fenestration and clinical symptoms has always been limited to apical root resection and placement of the root tip within the bony crypt. This result would often present resolution of clinical symptoms based on a few case studies. In this case report, we present a case in which apical resection alone did not resolve the patient's discomfort; on the contrary, it resulted in further bone loss and persistence of clinical symptoms. A corrective surgery was performed with the use of guided bone regeneration in conjunction with decortication of the cortical plate to induce bleeding. The patient symptoms resolved within a few weeks after the surgery, and the follow-up scan showed apical root coverage. Three-dimensional analysis was performed to compare the bony changes between the 2 surgeries and showed a significant amount of bone gain of around 200 mm3 and a 2-mm linear bone gain opposite the distobuccal root. The case presents a conservative approach to manage root fenestration of the buccal plate without further compromising the root apex.

Apicoectomy and connective tissuegraft: surgical approach for thetreatment of fenestrations: case report / Apicectomía e Injerto de tejido conectivo: abordaje quirúrgico para elmanejo de fenestraciones: reporte de caso

Apical fenestrations are a type of defect with the appearance of an osseous window from where dental rootsappear. They are considered labial or apical fenestrations when the root apex perforates the mucosa andbecomes exposed to the oral cavity. Because of its multifactorial etiology, including trauma from occlusion,thin bone plates and soft tissues, and dental malpositions, studies have been made about treatment protocolsin which different techniques have been described. This article describes the management betweenPeriodontics and Endodontics, looking for the reestablishment of periodontal and periapical health of anapical fenestration of a maxillary first right molar.

Las fenestraciones apicales son un tipo de defecto con apariencia de ventana ósea a través de la cual salenlas raíces dentales, y son consideradas fenestración labial o apical cuando los ápices perforan la mucosa yquedan expuestos al medio oral. Existe muy poca evidencia sobre este tipo de afecciones, sin embrago, hayestudios que demuestran que los dientes más afectados son los primeros molares superiores. Su etiologíamultifactorial, la cual incluye trauma oclusal, tablas óseas y tejidos blandos delgados, malposiciones dentales,entre otros, han llevado a la búsqueda de protocolos de manejo en los cuales se han descrito distintastécnicas. En este artículo se describe el manejo conjunto, entre Periodoncia y Endodoncia, buscando asíreestablecer la salud periodontal y periapical de una fenestración apical de un primer molar superior derecho.