bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palatal Tissue Enlargement After Subepithelial Connective Tissue Graft Harvest Associated With Anabolic Steroid Abuse
Authors: Soolari Ahmad , Soolari Ehsan , Shumaker Nicholas D. 
Published: April 2012

Introduction: Healing complications associated with androgenic anabolic steroid (AAS) abuse have received minimal attention in the periodontal literature. This case report describes an adverse healing event after palatal subepithelial connective tissue graft (SECTG) harvest associated with AAS abuse.Case Presentation: A 35‐year‐old white male was treated with an SECTG procedure to address gingival recession on the facial aspect of teeth #24 and #25. Donor tissue was harvested from the left hard palate via a single incision technique. The procedure was completed without complication. One week postoperatively, the patient presented with a large asymptomatic overgrowth of tissue from the palatal harvest site. Over the following 5 weeks of continued observation, the lesion demonstrated progressive, spontaneous resolution. Investigation of possible etiology revealed the subject was a recreational bodybuilder with admitted AAS abuse.Conclusions: Post‐surgical healing can be influenced by AAS abuse. Alterations in connective tissue metabolism and fibroblast activity are known sequelae of AAS abuse; however, patients may be reluctant to admit to steroid abuse during the presurgical interview. Surgeons should suspect the possibility of AAS abuse when postoperative complications present in a patient of muscular body type.
Cryosurgical Treatment of Gingival Melanin Pigmentation — A 30‐Month Follow‐Up Case Report
Authors: Ahmed Shaeesta Khaleel , George Joann Pauline , Prabhuji M. L. V. , Lazarus Flemingson 
Published: April 2012

Introduction: Cryosurgery is a branch of therapeutics that makes use of local freezing for the controlled destruction or removal of living tissues. Cryosurgery has been tried with satisfactory results for gingival depigmentation. However, documented evidence in the literature is extremely limited. The present case report describes the successful management of excessive gingival pigmentation by cryosurgery. The patient underwent follow‐up for 30 months.Case Presentation: A 21‐year‐old South Indian dark‐skinned female presented with dark brown to black gingival melanin pigmentation. The darkly pigmented gingiva had been present since birth. Cryosurgery using nitrous oxide and gas expansion cryoprobe cooled to −70°C was used for the depigmentation. The depigmentation was performed from maxillary right cuspid to maxillary left cuspid in a single appointment. The patient reported no adverse effects and no repigmentation of the treated areas for a period of 30 months.Conclusions: Cryosurgery is an easy procedure, with lack of bleeding and scar formation. The esthetic outcome may be maintained for 30 months as shown in the present case. Cryosurgery can be considered a desirable treatment option for gingival depigmentation.
The Use of a Xenogeneic Collagen Matrix as an Interpositional Soft‐Tissue Graft to Enhance Peri‐Implant Soft‐Tissue Outcomes: A Clinical Case Report and Histologic Analysis
Authors: Mandelaris George A. , Lu Mei , Rosenfeld Alan L. 
Published: April 2012

Introduction: Keratinized and dense peri‐implant soft tissue around implants has been associated with better tissue health, less bone loss, and improved esthetics. The purpose of this case report is to evaluate a new, xenogeneic collagen matrix (CM) as an interpositional soft‐tissue graft to enhance peri‐implant soft‐tissue thickness. To our knowledge, this is the first such case report to include soft‐tissue biopsies and histologic analysis.Case Presentation: After extraction and bone grafting of a mandibular left first molar, the patient received a dental implant, and CM was used as an interpositional soft‐tissue graft. Clinical healing was uneventful, and the impression of enhanced soft‐tissue volume/thickness was observed. At 10 weeks, biopsies were taken from the operative site and from a contralateral, non‐operated site. Histologic assessment of the operative site demonstrated normal squamous epithelium and lamina propria. Tissue growing into the residual CM also appeared normal, with no inflammatory cells seen in the graft area. Vascular blood vessels were observed growing into the matrix. Control and test sites were comparable.Conclusions: This case report and the first examination of a human biopsy around a dental implant demonstrate that CM holds promise as an effective, time‐efficient, and reduced morbidity alternative to autogenous graft harvest for the promotion of peri‐implant soft‐tissue thickness. CM was easy to handle, place, and suture, and histologic analysis indicated a benign tissue response resulting in an organized and attached connective tissue similar to native, undisturbed periodontal tissue.
Conservative Treatment of Localized Juvenile Spongiotic Gingival Hyperplasia
Authors: MacNeill Simon R. , Rokos James W. , Umaki Michael R. , Satheesh Keerthana M. , Cobb Charles M. 
Published: April 2012

Introduction: Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a recently described uncommon and distinctive form of inflammatory hyperplasia. Treatment of this condition has varied from surgical excision to no treatment followed by spontaneous remission. This case report demonstrates successful management of the lesion using a conservative treatment approach.Case Presentation: A 14‐year‐old male with negative medical and dental histories presented with LJSGH. The vivid red lesions involved the papillary and marginal gingiva of all maxillary anterior teeth. Initially, the lesion developed as a single red patch‐like area involving the maxillary left cuspid. Subsequently, the lesion displayed a linear pattern of spread to involve successively more teeth in the anterior sextant. Biopsy revealed hyperplastic elongated epithelial rete pegs, atrophy of the overlying stratified squamous epithelium with mild spongiosis, neutrophilic exocytosis, and a highly vascular connective tissue with a dominant infiltrate of chronic inflammatory cells. The lesion responded to treatment consisting of a mild surface cauterization followed by topical application of a 0.05% clobetasol ointment four times per day for a period of 4 weeks.Conclusion: This case report demonstrates that LJSGH can be successfully managed by conservative therapy, thereby avoiding potential gingival margin defects that may result from a surgical ablation of the lesion.
Non‐Plaque‐Induced Gingivitis Associated With Isotretinoin: A Case Report
Authors: Mahajan Ajay , Bharadwaj Ashu , Mahajan Poonam 
Published: April 2012

Introduction: Isotretinoin (13‐cis‐retinoic acid), a synthetic vitamin A derivative, is used to treat a wide variety of dermatologic conditions, including severe acne. Although isotretinoin has revolutionized the management of acne vulgaris, concerns continue regarding the adverse effect profile of isotretinoin. Mucocutaneous reaction is the most commonly observed adverse side effect of isotretinoin use, but the involvement of gingival mucosa has rarely been reported. To our knowledge, this is the first‐ever case report of gingivitis associated with isotretinoin.Case Presentation: A 19‐year‐old female was referred to the Department of Periodontics, Himachal Pradesh Government Dental College and Hospital, Shimla, India, for the treatment of persistent severe gingivitis. The history of the patient revealed that she had been on 10 mg/day isotretinoin regimen for the treatment of nodular facial acne for 6 months. In the absence of an obvious cause, the condition was diagnosed as isotretinoin‐associated gingivitis. After consultation with the dermatologist, the drug was stopped and the patient responded favorably to periodontal treatment.Conclusion: Non‐plaque‐induced, isotretinoin‐associated gingivitis should always be suspected in a patient who is taking isotretinoin and has persistent gingivitis that does not respond to periodontal treatment.
Successful Gingival Depigmentation With Laser‐Patterned Microcoagulation: A Case Report
Authors: Allen Edward P. , Gladkova Natalia D. , Fomina Yulia V. , Karabut Maria M. , Kiseleva Elena B. , Feldchtein Felix I. , Altshuler Gregory B. 
Published: April 2012

Introduction: Current methods for gingival depigmentation, including mechanical surgery, cryosurgery, laser treatments, and radiosurgery, create significant patient discomfort and risk of complications, thereby reducing attractiveness of the depigmentation procedure for many patients. To our knowledge, this case report presents a first‐time application of a new technology, laser‐patterned microcoagulation (LPM) based on the concept of fractional laser photothermolysis that was successfully applied in dermatology and ophthalmology.Case Presentation: One patient was treated for local hyperpigmentation of the labial attached gingiva in the maxillary anterior area. A diode laser with wavelength 980 nm and power 20 W was used to create microcoagulation columns with a 30% area filling factor. Two treatments were performed, 2 weeks apart, without anesthesia. The patient was followed for 5 months. The discomfort during the procedure was tolerable without anesthesia. Healing was uneventful and visually completed with significant reduction of pigmentation at 2 weeks after treatment. Complete visual depigmentation was observed at both 2 weeks and 2 months after the second treatment.Conclusions: To our knowledge, this is the first clinical case of hyperpigmentation treatment using LPM, demonstrating feasibility of a new, minimally invasive and effective method of localized gingival hyperpigmentation removal. The patient discomfort is significantly less than that reported for other methods for depigmentation.
Primary Non‐Hodgkin Lymphoma of Palatal Gingiva
Authors: Sharma Rajinder K. , Yadav Vikender S. , Kataria Sant P. , Tewari Shikha , Narula Satish C. 
Published: April 2012

Introduction: Non‐Hodgkin lymphomas (NHLs) are a heterogeneous group of lymphoproliferative malignancies that can disseminate to organs and tissues that do not ordinarily contain lymphoid cells (extranodal sites). Primary extranodal NHL of the oral cavity is rare, and gingiva is one of the rarest intraoral sites involved. The majority of oral NHLs reported are of diffuse large B‐cell type. Such lymphomas are more prevalent in immunocompromised patients. Because of their malignant nature, early recognition, diagnosis, and treatment are essential for a patient's survival. To the best of our knowledge, this report presents the first case of diffuse mixed small and large B‐cell lymphoma involving the gingiva in a non‐immunocompromised patient.Case Presentation: A female patient presented with a growth located on the palatal aspect of the right maxillary molar region involving marginal and interdental gingiva. Routine laboratory tests and clinical examination were within normal limits. An incisional biopsy of the gingival tissue was evaluated using histologic techniques and immunohistochemistry. A diagnosis of extranodal diffuse mixed small and large B‐cell lymphoma was established. The patient underwent a complete workup to rule out other systemic lesions, thereby supporting the primary nature of the lesion.Conclusion: Gingival overgrowth may rarely be the first manifestation of extranodal NHL. Only histopathological examination of the specimen with immunohistochemistry can ascertain a confirmed diagnosis of NHL. The present case report stresses the importance of routine biopsy examination for growth lesions of long duration when an infectious etiology has been ruled out, even if the lesions appear benign.
An Unusual Plasma Cell Gingivitis Case Related to Use of Herbal Toothpowder
Authors: Agarwal Sangita , Ajmera Neha , Chatterjee Anirban , Madaiah Hemalata 
Published: April 2012

Introduction: Plasma cell gingivitis (PCG) is a rare benign condition of gingiva marked by dense infiltration of plasma cells into the subepithelial gingival tissue. Considered to be a true hypersensitivity reaction, it leads to edematous enlargement of gingiva extending up to the mucogingival junction. Identification and removal of the allergen leads to remission of the lesion. This case describes an unusual case of PCG.Case Presentation: The patient did not respond well to conventional periodontal therapy. Discontinuation of herbal toothpowder with surgical periodontal therapy led to remission of gingival enlargement. Massive enlargement responded well to removal of allergen and surgical periodontal therapy. There was no evidence of recurrence at the 18 month follow‐up.Conclusion: Clinicians should be aware of the adverse effects of herbal agents used in dentifrices, and caution should be exercised against excessive use of such products.
Use of Platelet‐Rich Plasma Combined With Hydroxyapatite in the Management of a Periodontal Endosseous Defect Associated With a Palato‐Radicular Groove: A Case Report
Authors: Guruprasad C.N. , Pradeep A.R. , Agarwal Esha 
Published: April 2012

Introduction: Various root developmental anomalies, such as palato‐radicular groove, have been associated with worsening the periodontal condition. Platelet‐rich plasma (PRP), an autologous concentration of platelets, has been reported to significantly enhance bone and soft‐tissue healing and the combination of PRP and a hydroxyapatite (HA) osseous graft has been demonstrated to be efficacious in the treatment of periodontal endosseous defects. Here, we present a 1‐year follow‐up report of such a clinical case, treated by the combined use of PRP and HA osseous graft for periodontal regeneration and, finally, restorative therapy.Case Presentation: A 36‐year‐old Indian female reported with pain in the upper maxillary incisor region. On clinical and radiologic examination, a deep 3‐wall periodontal endosseous defect was found mesial to the maxillary left lateral incisor that was etiologically associated with the presence of a palato‐radicular groove, leading to the development of a periapical lesion. Endodontic therapy, non‐surgical periodontal therapy, and surgical periodontal therapy with a mixture of PRP gel and HA were performed. One‐year examination showed uneventful healing and complete elimination of the periodontal pocket.Conclusions: A palato‐radicular groove may serve as a pathway for the development of a periodontal endosseous defect and for pulpal involvement. The combination of PRP and HA may be efficacious in the treatment of such a periodontal endosseous defect. Additional research should be performed to evaluate the efficacy of PRP and HA in the treatment of periodontal endosseous defects.
Unusual Implant Failure and Concurrent Lung Infection
Authors: Deporter Douglas , Hutcheon Michael 
Published: April 2012

Introduction: A patient with a history of treated periodontal disease with multiple tooth loss was seeking dental implant treatment.Case Presentation: After aggressive sanative therapy and a single pocket‐reduction surgery, treatment proceeded with one mandibular implant, one immediate maxillary implant, and minor sinus grafting using the crestal approach. Both implants failed to integrate due to infections that appeared unrelated to known periodontal pathogens. Patient referral for additional medical investigation led to diagnosis of serious lung infections. Once the lung conditions were managed with antibiotics, implant retreatment was successful.Conclusion: When dental implants fail, every attempt should be made to understand why and include further medical investigation where indicated.
Severe Localized Gingival Recession Developing During Pregnancy
Authors: Parashis Andreas O. , Tatakis Dimitris N. 
Published: April 2012

Introduction: Gingival recession typically develops over a long period of time. Development or progression of gingival recession in a short time and in the absence of acute trauma is exceedingly rare. The aim of this case report is to present a case of severe gingival recession developing in a systemically healthy patient during the last trimester of a routine pregnancy.Case Presentation: A 34‐year‐old woman, successfully treated 3 years earlier for a localized gingival recession on tooth #24, compliant with home care and maintenance visits, discontinued maintenance during pregnancy. A localized 2‐mm deep Miller Class I recession defect on tooth #26 was under follow‐up and had been stable during maintenance. The patient presented at 2‐months postpartum. She reported that she had noticed localized inflammation and progression of the recession on tooth #26 during the last gestational trimester; she denied any history of trauma. During examination, the recession on tooth #26 had progressed into a 6‐mm deep Miller Class II defect. The defect was treated with a connective tissue graft procedure. At 14 months after surgery, the clinical outcome remained satisfactory and stable.Conclusions: Rapid and severe localized gingival recession can occur during routine pregnancy. In light of the evidence indicating safety of routine periodontal care during pregnancy, pregnant females should be encouraged to continue their maintenance periodontal care to minimize the potential of irreversible sequelae from pregnancy‐associated gingival inflammation.
Enamel Matrix Proteins and Periodontal Wound Healing and Regeneration
Authors: Sculean Anton , Alessandri Regina , Miron Richard , Salvi Giovanni E. , Bosshardt Dieter D. 
Published: April 2012

Introduction: The goal of regenerative periodontal therapy is the reconstitution of lost periodontal structures (i.e., the new formation of root cementum, periodontal ligament, and alveolar bone). Results from preclinical and clinical research in the last decade have provided evidence on the biologic rationale and clinical applications of an enamel matrix derivative (EMD) protein in periodontal wound healing and regeneration.Case Presentations and Literature Overview: This paper will provide an overview of the biologic rationale for using enamel matrix proteins (EMPs) in regenerative periodontal therapy. Based on the available preclinical and clinical evidence, the main clinical indications for using EMD in regenerative periodontal therapy will be discussed.Conclusions: The available data provide evidence of the biologic rationale of EMPs to support periodontal wound healing and regeneration. The application of EMD in conjunction with a surgical access may result in substantial regeneration of root cementum, periodontal ligament, and bone, thus improving the clinical outcomes in intrabony, recession, and Class II furcation defects.
Comprehensive Periodontal Regenerative Care: Combination Therapy Involving Bone Allograft, a Biologic, a Barrier, and a Subepithelial Connective Tissue Graft to Correct Hard‐ and Soft‐Tissue Deformities
Authors: Rosen Paul S. 
Published: April 2012

Type of Case: A 70‐year‐old white female was referred for evaluation and treatment of isolated periodontal lesions throughout her mouth. Her chief concern was the soft‐tissue deformity that was present on her maxillary right canine. Radiographic evaluation of this area revealed that, along with this mucogingival defect, there was an intrabony lesion that required treatment.Case Presentation: The ability to enhance the prognosis and appearance of this tooth by restoring the hard‐tissue support and soft‐tissue profile in the same procedure has rarely been reported in the literature. This case report focuses on a layered approach that simultaneously addresses both aspects of the patient's problem. Treatment involved a mineralized allograft, a biologic agent, an amnion–chorion barrier, and a subepithelial connective tissue graft on a root treated with tetracycline.Conclusions: The clinical and radiographic results at 6 months suggest a very favorable result. Efforts to treat teeth that have both hard‐ and soft‐tissue deformities should consider combination therapies that address both concerns.
Intravenous Bisphosphonates for Osteoporosis and Implant Placement
Authors: Reddy Michael S. , Geisinger Maria L. , Liu Perng‐Ru , Holmes Carolyn M. , Vassilopoulos Philip J. , Geurs Nicolaas C. 
Published: April 2012

Focused Clinical QuestionIn a patient receiving intravenous infusion of nitrogen containing bisphosphonates for management of osteoporosis, is surgical implant treatment contraindicated because of the risk of impaired bony wound healing and osteonecrosis of the jaw?Clinical ScenarioA 64‐year‐old postmenopausal woman who leads a busy life and works full time as a business executive presents with a fracture of her maxillary central incisors teeth #8 and #9. She has been a periodontal maintenance patient for the past 20 years with excellent oral hygiene. One month earlier, she experienced trauma to her anterior teeth by walking into a closed patio door. She appears younger than her stated age, and her overall health is good except for a history of postmenopausal osteoporosis diagnosed using a bone mineral density evaluation with a T‐score at lumbar spine of −2.6. Currently, her only medication is a yearly intravenous infusion of zoledronic acid, which she has received for the past 3 years. The reason for this visit is to inform her that the teeth have a hopeless prognosis based on the progressive symptoms and will need to be extracted, and to discuss treatment options, risks, benefits, and alternatives.
Systemic Teriparatide Administration Promotes Osseous Regeneration of an Intrabony Defect: A Case Report
Authors: Bashutski Jill D. , Kinney Janet S. , Benavides Erika , Maitra Samopriyo , Braun Thomas M. , Giannobile William V. , McCauley Laurie K. , Eber Robert M. 
Published: April 2012

Introduction: Teriparatide comprises the first 34 amino acids of parathyroid hormone and is a systemic anabolic agent that is Food and Drug Administration approved for the treatment of osteoporosis but not for periodontitis. To our knowledge, this is the first clinical case report to document the treatment of a patient with severe periodontitis using an open‐flap debridement procedure in conjunction with teriparatide.Case Presentation: A 45‐year‐old female patient was diagnosed with severe chronic periodontitis, including the presence of an intrabony defect on tooth #6. She received open‐flap debridement surgery in conjunction with daily systemic administration of 20 μg teriparatide, oral vitamin D, and calcium supplements for 6 weeks. Radiographic, clinical, gingival crevicular fluid (pyridinoline cross‐linked carboxy‐terminal propeptide of type I procollagen, procollagen type 1 N‐propeptide, and osteocalcin), and serum parameters (parathyroid hormone, bone alkaline phosphatase, calcium, and 25‐hydroxyvitamin D) were assessed. Treatment outcomes were evaluated over 4 years, with successful radiographic and clinical results throughout the follow‐up period.Conclusion: Teriparatide administration in conjunction with traditional open‐flap debridement surgery offers potential for the treatment of severe intrabony defects resulting from chronic periodontitis.