#Pendor right to rule free#

All probing depth measurements around the tooth were within the normal limit, and the fenestrated area could not be probed through the gingival sulcus.

#Pendor right to rule free#

The area was free of pus and calculus, and the surrounding gingiva appeared whitish in color. The fenestration was oval in shape, measuring approximately mm in diameter.

On examination, a portion of the root of mandibular left lateral incisor was visible through a gingival and alveolar bone fenestration on the labial surface (Figure 1). History of two years of gutka chewing with placement of the gutka quid in the lower labial vestibule was reported. Case ReportДЄ 27-year-old male reported to the authorsвЂ™ department with a complaint of hypersensitivity and burning sensation in the lower left front region since one month.

A conservative incision technique for the preparation of the tunnel was used. Treatment of the fenestration, as well as simultaneous root coverage of a class I recession defect on the adjacent tooth, creating a pouch and subjacent tunnel is described. The following case describes a rare situation of occurrence of a gingival fenestration in a gutka chewer. Habitual gutka use has been associated with the occurrence of several oral mucosal disorders, including oral submucous fibrosis (OSF), oral cancer, and periodontal disease. Gutka is chiefly a mixture of powdered tobacco, areca nut (fruit of Areca catechu), and slaked lime (aqueous calcium hydroxide), usage of which is seen mainly in the Indian subcontinent and also enjoyed by immigrant communities settled in Europe and the United States. Highly successful root coverage was reported with these two techniques. Zabalegui and others treated multiple gingival recessions by creating a tunnel under the areas of gingival recession to receive the connective tissue graft thus avoiding dissecting the intermediate papilla and improving blood supply to the flap. Raetzke in 1985 described a bilaminar technique for isolated recession defects, creating an envelope or pouch around the recession area to receive connective tissue graft. However, greater predictability of results became achievable only with the introduction of bilaminar connective tissue grafting techniques. Several innovations, modifications, and variations have been developed for surgical root coverage since Grupe and Warren first described the laterally positioned flap. Furthermore, it must be remembered that exposed roots are prone to abrasion and erosion. Recession defects are treated to resolve a variety of patient-centered concerns including, but not limited to, root sensitivity, increased potential for root caries, difficulty in plaque control, and esthetics. Gingival recession may be caused by periodontal disease, improper oral hygiene, frenal pull, bone dehiscence, improper restorations, tooth malposition, viral infections of the gingiva, and oral habits. Gingival fenestration defects may create problems regarding plaque control, root hypersensitivity, and esthetics. Gingival fenestrations are of uncertain etiology and have rarely been reported in the dental literature. Treatment of the fenestration along with coverage of an adjacent recession defect in a single-step procedure using a pouch and tunnel technique is described. This report describes the occurrence of a gingival fenestration that developed secondarily to a gutka chewing habit. Though treatment of mucosal fenestration occurring in association with chronic periapical inflammation has been reported previously, the occurrence and treatment of gingival fenestration have not been documented in great detail. Gingival fenestration means the exposure of the tooth due to loss of the overlying bone and gingiva. Gingival fenestration defects are a rare phenomenon.