Department of Periodontics & Oral Implantology, Dr. D. Y. Patil Dental College & Hospital, Pune, India.
J Endod. 2010 Jan;36(1):164-8. doi: 10.1016/j.joen.2009.06.012.
Mucosal fenestrations are infrequently encountered in clinical practice, and as such, their management has not been reported often. Their treatment might be further complicated by communication, with the oral environment making them susceptible to the deposition of plaque and calculus, a secondary factor in preventing reformation of mucosal covering.
Three cases of mucosal fenestrations are presented, of which 2 were nonvital and were treated endodontically. Full-thickness flap was elevated; root-end resection and root-end filling with light-cured glass ionomer were done. In the third case, the tooth was vital, so the fenestrated root surface was just planed. The areas were then covered with connective tissue graft before repositioning the flap.
At subsequent follow-up, the mucosal fenestrations were completely healed by soft tissue coverage, and postoperative radiographs revealed good periapical bone healing in the first 2 cases, and there was maintenance of vitality in the third case.
Careful diagnosis of mucosal fenestrations can help elucidate the underlying cause, and combining nonsurgical and surgical therapies can be a good treatment option for their successful management.
在临床实践中,黏膜开窗很少见,因此,它们的治疗方法也很少被报道。由于口腔环境容易使菌斑和牙石沉积,这是阻止黏膜覆盖重新形成的次要因素,因此其治疗可能会更加复杂。
报告了 3 例黏膜开窗病例,其中 2 例为无活力的牙齿,并进行了根管治疗。进行全厚瓣掀起术;进行根尖切除和光固化玻璃离子根端填充。在第 3 例中,牙齿有活力,因此仅对开窗的根面进行了平整。然后,在重新定位瓣之前,用结缔组织移植物覆盖这些区域。
在随后的随访中,黏膜开窗完全被软组织覆盖愈合,术后 X 线片显示前 2 例有良好的根尖周骨愈合,第 3 例保持活力。
对黏膜开窗的仔细诊断有助于阐明其潜在原因,将非手术和手术治疗相结合是成功治疗的一种很好的选择。