Application of Hard and Soft Tissue Regenerative Approach in Predictable Management of Peri-Implantitis: A Five-Year Follow-Up Case Report.

As implant dentistry expands, the number of implants being placed increases, and so does the prevalence of associated complications, resulting in implant failure if not timely attended. The present case report aims to discuss the successful regenerative management of peri-implantitis by both hard and soft tissue augmentation with a five-year follow-up. A 60-year-old male reported a chief complaint of purulent discharge, 7 mm peri-implant probing depth, and radiographic bone loss with no pathologic mobility of the dental implant. The reflection of the full-thickness flap revealed a circumferential defect. Guided bone regeneration (GBR) was performed using a combination of autogenous and alloplastic bone grafts around the implant site. To maintain the peri-implant marginal bone level, soft tissue augmentation was done using the vestibular incision subperiosteal tunnel access (VISTA) approach, after six months. A five-year follow-up showed a significant bone fill and stable soft tissue around the implant clinically and radiographically.

Management of massive peripheral ossifying fibroma using diode laser.

Peripheral ossifying fibroma (POF) represents a non-neoplastic, reactive lesion of gingiva. The precise etiopathogenesis of POF is unclear; however, it is suggested to originate from the connective tissue of periodontal ligament. This lesion predominantly occurs in the maxillary anterior region. The standard treatment protocol involves surgical excision followed by the biopsy of lesion. The reactive nature and unpredictable course attribute to a high recurrence rate of the lesion; hence, proper postoperative monitoring and follow-up of the lesion are necessary. The present case was surgically managed using diode laser and did not show any sign of recurrence during the follow-up period of 6 months. Minimum intraoperative bleeding and postoperative pain, ease of operation, and patient's acceptance enable laser-assisted growth excision as a better treatment modality to other conventional surgical procedures, thus offering diode laser as a viable and effective treatment alternative in the management of massive overgrowth.

Management of a Two-rooted Maxillary Central Incisor Using Cone-beam Computed Tomography: Importance of Three-dimensional Imaging.

We report a rare case of a two-rooted maxillary central incisor, stressing the importance of three-dimensional imaging in treatment planning and conservative approach of management. Endodontic treatment of this central incisor was carried out with a successful outcome.

Clinical management of a complicated crown-root fracture using autogenous tooth fragment: A biological restorative approach.

Trauma resulting in crown-root fracture is one of the most challenging fracture types. However, biologic width involvement should be carefully evaluated. Reattachment of tooth fragment to a fractured tooth remains as the treatment of choice because of its simplicity, natural esthetics, and conservation of tooth structure. The reattachment procedure using composite resin should be considered if the subgingival fracture can be exposed to provide isolation. This report presents a case of complicated crown-root fracture of permanent maxillay left central incisor, involving the biologic width in a 10-year-old girl. The traumatized tooth was treated endodontically. Access to the subgingival margins was gained by orthodontic extrusion followed by gingivectomy. The fractured fragment was reattached using bonding system and composite resin.

Ascorbic acid deficiency: a case report.

Scurvy is well known since ancient times, but it is rarely seen in the developed world today owing to the discovery of its link to the dietary deficiency of ascorbic acid. It is very uncommon in the pediatric population, and is usually seen in children with severely restricted diet attributable to psychiatric or developmental disturbances. The condition presents itself by the formation of perifollicular petechiae and bruising, gingival inflammation and bleeding, and, in children, bone disease. We report a case of scurvy in a 10-year-old developmentally delayed boy who had a diet markedly deficient in vitamin C resulting from extremely limited food choices. He presented with debilitating bone pain, inflammatory gingival disease, and perifollicular hyperkeratosis. The diagnosis was made based on clinical and radiographic findings. The importance of diet history is emphasized. We present this case with the aim to help the clinician identify scurvy and implement treatment for a potentially fatal but easily curable disease.

Talon cusps, macrodontia, and aberrant tooth morphology in Berardinelli-Seip syndrome.

Berardinelli-Seip syndrome is a congenital form of generalized lipodystrophy, transmitted as an autosomal recessive trait. It is well documented in medicine and skin. It is a rare disorder caused by mutations of AGPAT2 gene or BSCL2 gene. We present an interesting case of Seip-Berardinelli syndrome in female siblings aged 12 years and 14 years who presented with endocrine disturbances along with dental manifestations including talon cusps, macrodontia, aberrant tooth morphology, and severe generalized crowding. The presence of such dental abnormalities may represent an interesting association with endocrine disturbances. Such cases require thorough investigations and appropriate treatment.