Healing of periodontal flaps when closed with silk sutures and N-butyl cyanoacrylate: A clinical and histological study

<b>Background:</b> The closure of the periodontal flaps post-surgery is a necessity for attainment of a primary union between the flap margins and the establishment of a healthy dentogingival junction. N-butyl cyanoacrylate is a tissue adhesive, which can be used for the closure of the incised wounds to overcome the problems associated with conventional suture materials like silk. <b> Objective: </b> The present study was carried out to assess the healing of the periodontal flaps when closed with the conventional silk sutures and N-butyl cyanoacrylate. <b> Materials and Methods:</b> The study was carried out on 24 patients who needed flap surgical procedure for pocket therapy. <b> Results:</b> It was found that healing with the cyanoacrylate is associated with less amount of inflammation during the first week when compared with silk. However, over a period of 21 days to 6 weeks, the sites treated with both the materials showed similar healing patterns. <b> Conclusion: </b> It can be concluded that cyanoacrylate aids in early initial healing

Evaluation of soft tissue marginal stability achieved after excision with a conventional technique in comparison with laser excision: A pilot study

Background: Soft tissue excision around natural teeth is carried out to increase the clinical crown lengths, expose the caries apical to the gingival margins and to correct irregular and un-esthetic soft-tissue contours. Aims: The study was carried out with an aim to evaluate the stability of the soft tissue margins after excision either with a laser or scalpel. Materials and Methods: A total of 20 patients indicated for soft tissue excision for correcting soft tissue discrepancies were selected. The patients with thick gingival biotype were included in the study. They were grouped randomly into excision by laser or scalpel methods. The change in the soft tissue positions from the time of excision to 1-month follow-up were evaluated immediate postoperatively, after 2 weeks and after 1-month postrestoration. Results: The soft tissues remained stable in the laser group at 1-month follow-up, in contrast to the scalpel group and were found to be statistically significant, (Student′s t-test) (P < 0.05). Conclusion: The soft tissue margins are more stable and stay at the point they were excised with lasers when compared with scalpel

The influence of soft tissue biotype on the marginal bone changes around dental implants: A 1-year prospective clinico-radiological study

Background: The peri-implant mucosa undergoes surgical and bacterial assaults in various stages of implant therapy, however, the literature on changes occurring in the peri-implant mucosa is minimal. This study was thus conducted to evaluate the change in the peri-implant mucosal thickness and its effect on the marginal bone levels around dental implants treated in a conventional two-stage implant therapy. Materials and Methods: A total of 36 implants were placed in 22 subjects. Two subjects dropped out. Thirty-three implants in 20 subjects were then evaluated. Initial mucosal thickness, marginal bone levels on radiographs, pain, and exudation were evaluated. All these parameters were recorded at the time of implant placement, at the time of cementation of final restoration, 6 months and 12 months post cementation/restoration. Results: The peri-implant mucosal thickness reduced from implant placement to second stage and till restorations and was statistically significant, in both the thick and thin biotypes, however, at 12 months there was a rebound of the tissue thickness, which was more in the thick biotype (P < 0.05). At 1-year follow-up, there was a reduction in the marginal bone levels, which was more in the thick biotype as compared to the thin biotype (P < 0.05). Conclusion: The mucosa at implant sites undergoes a reduction in thickness from the time of implant placement till the placement of final restorations. The placement of the final restorations and then end of active therapy leads to a rebound of the tissue thickness. Sites with thicker tissues preoperatively have a lesser bone loss and better rebound as compared to thinner tissues

Crown lengthening procedure following intentional endodontic therapy for correction of supra-erupted posterior teeth: Case series with long-term follow-up

Context: The crown lengthening procedure (CLP) is routinely carried out to correct gingival levels and achieve esthetic contours and adequate crown lengths for restorative purposes. Though the short-term outcomes have been found to be stable, long-term results are not much reported. Aims: To evaluate the long-term stability of the marginal bone levels, gingival levels, and the status of the teeth, which underwent endodontic therapy, followed by CLP and final restorations. Settings and Design: Institutional setting, long-term case series. Materials and Methods: Case records of the patients who underwent CLP and endodontic therapy for corrections of the supra-erupted teeth to regain the lost interocclusal spaces were retrieved, and the cases with complete set of the clinical and radiographs were taken. All the cases were recalled and bone levels on the radiographs, bleeding on probing, probing pocket depths, and changes in the soft tissue margins were evaluated. Statistical Analysis Used: Descriptive analysis. Results: A total of 25 teeth had undergone CLP and endodontic therapy and final restorations for a minimum of 24 months. The mean post-restorative duration was 50.8 ± 22.48 months (range 24–96 months). All the teeth were functional and asymptomatic with 100% survival. Interdental bone loss of 1 mm, probing pockets of 5 mm, and 1 mm buccal recession were observed in 16% of the sites. The amount of interocclusal space regained was adequate to restore the missing teeth in the opposing arch. Conclusions: The CLP is a predictive procedure for correction of supra-erupted teeth. The survival of the teeth that underwent the procedure in the present study was 100% over 24–96 months

Rehabilitation of a missing ear with an implant retained auricular prosthesis

Burns can leave a patient with a severely debilitating disability even after treatment. The objectives of burn rehabilitation are to minimize the adverse effects caused by the injury while rehabilitating the patient′s physical and psychological well-being, maximizing social integration. Long-term success of maxillofacial prostheses mainly depends on the retention. Extra oral implant retained prostheses have proved to be a predictable treatment option for maxillofacial rehabilitation. Replacement of a severely deformed external ear with burned tissues may be satisfactorily accomplished by a cosmetic prosthesis anchored by implants integrated in the skull. The use of such implants is now a well-recognized method for creating a stable result in maxillofacial rehabilitation. This case report describes a safe, simple and economical method for the rehabilitation of a patient with missing right auricle using an implant supported silicone prosthesis. The implant was placed in the mastoid region of the temporal bone. Reconstruction of the ear was done with auricular silicone prosthesis, retained using magnets incorporated in an autopolymerizing resin shim to decrease the weight of the prosthesis on a single implant. This method eliminates the need of tedious laboratory procedures and exact casting and fitting requirements of a metal substructure while minimizing the overall weight and cost of the prosthesis while maintaining adequate support, esthetics and retention of the prosthesis

Accidental identification of accessory mental nerve and foramen during implant surgery

The accessory mental nerve and the corresponding foramen are not a very common occurrence. In the current case report, we present the notice of an accessory mental nerve in the mandibular molar area during implant placement. The case was managed well without any complications