Management of fenestration using bone allograft in conjunction with platelet-rich fibrin.

Fenestration and dehiscence are said to be anatomical variations of cortical bone and not true pathological entities. They represent window-like defects covered by periosteum and overlying gingiva with or without the intact marginal bone. The etiology of such defects is still unclear, though many hypotheses such as occlusal traumatism, trauma, and variation in root bone angulation have been put forward. Diagnosis of such defects is challenging clinically, and they cannot be appreciated in conventional radiographs. In many instances, they are accidentally discovered during periodontal and oral surgical procedures. These defects, if not treated, can affect prognosis and complicate healing of the affected teeth. Treatment of such cortical bony defects is challenging and involves the use of potential regenerative materials to aid in regeneration. This case report describes the successful management of such a defect, discovered through exploratory flap approach, using PRF in conjunction with bone allograft.

The facial skeleton: Armor to the brain?

BACKGROUND: With the development of urban setting worldwide, the major issue of concern is the increase in the mortality rate in the population due to road traffic accidents. The face, being the most exposed region is susceptible to injuries and maybe associated with injuries to the adjacent neuro-cranium. The literature has conflicting views on the relationship between facial fractures and head injuries with some authors opining that the facial skeleton cushions the brain while some other authors claim that the facial fractures act as indicators for head injuries. OBJECTIVES: To analyze the correlation between the facial fractures and head injuries and to assess if the facial skeleton acts to protect the brain from injury. PATIENTS AND METHODS: A prospective study that included patients who reported to the emergency department of Basaveswar Teaching and General Hospital, Gulbarga, during 2 years, between August 2013 and July 2015 was conducted. A total of 100 patients with facial fractures were enrolled in the study. RESULTS: Head injuries were sustained by 51 patients in the study. Maximum number of patients was in the age group of 20-29 with a male to female ratio of 10.1:1. The mandible was the most frequently fractured bone in the facial skeleton followed by the zygomatico-maxillary complex. A majority (96%) of patients with head injuries had fractures of either the upper third or the middle third of the face. Contusions and pneumocephalus were the most common head injury encountered. The Glasgow Coma Scale score was significantly lower in patients with associated head injuries as compared to those patients with facial trauma alone. The mortality rate in the study was 2% with both the victims having sustained middle third and upper third fractures respectively with associated head injuries. CONCLUSION: The facial skeleton does not act to cushion the brain from injury but, in fact, the facial trauma victims should be considered potential head injury patients.

Bimaxillary unilateral gingival fibromatosis with localized aggressive periodontitis (eating the tooth at the same table).

This case reports a unique presentation of two different clinical entities amidst few similarities and differences. Usually, aggressive periodontitis and gingival fibromatosis occur independently. Their simultaneous occurrence is rarely found. This report deals with the clinical features and management aspect of such a case.

Scurvy-scorbutic siderosis of gingiva: A diagnostic challenge - A rare case report.

This case reports a rare condition of scurvy which posed a diagnostic difficulty. However, a thorough medical and diet history, along with clinical and histopathological examination aided in prompt diagnosis and successful management of the case. Occurrence of scurvy in today's contemporary society is said to be rare. Lack of fresh fruits and vegetables in the diet can lead to this condition. Diagnosis may be difficult due to its rarity and presence of non specific symptoms, which may pose a challenge to the clinician. A comprehensive history, clinical examination along with clinical and histopathological features led to arrive at a proper diagnosis. Local procedures and systemic therapy aided in the successful management of the case. A marked improvement in the gingival status and in the physical well being of the patient resulted after treatment. This case report describes the various manifestations of scurvy that posed a diagnostic challenge to the clinician. This condition which can be fatal if untreated can be easily prevented with inclusion of healthy food in the diet and modification in the lifestyle.