{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:48:05Z","timestamp":1792025285127,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T00:00:00Z","timestamp":1639958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Mucosal fenestrations are infrequent and often challenging to treat depending on the extent of soft and hard tissue destruction. This article presents the successful management of a relatively larger mucosal fenestration associated with complete absence of buccal bone plate in a mandibular incisor secondary to trauma\u2010induced periapical pathosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical considerations<\/jats:title><jats:p>After non\u2010surgical endodontic therapy, surgery was performed for debridement of the osseous defect, root resection\/shaping, connective tissue graft (CTG) placement on the affected root surface and platelet rich fibrin (PRF) in periapical osseous defect rather than use of bone graft and\/or barrier membrane. Healing was uneventful, however, a small mucosal defect remained at 2\u2009weeks follow\u2010up. After 3\u00a0months of primary surgery, a corrective surgery was performed utilizing an \u201cincision\u2010free\u201d approach i.e. tunnel technique with CTG in contrast to the contemporary flap approach. At 18\u2009months follow\u2010up, complete closure of the mucosal defect with a thick gingival biotype, normal sulcus depth, and good esthetic outcome were achieved. No recurrence and any clinical signs of infection or inflammation were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on the outcomes of present case, an early intervention utilizing the minimally invasive surgical therapy and autologous biomaterials may be considered a viable approach to treat such complex lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical significance<\/jats:title><jats:p>Endodontic therapy in combination with PRF and CTG appears to provide successful outcomes in treatment of a large mucosal fenestration with periapical osseous defect.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jerd.12855","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T08:45:18Z","timestamp":1639989918000},"page":"445-450","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Successful management of a large mucosal fenestration at 18\u2010months follow\u2010up"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9359-153X","authenticated-orcid":false,"given":"Vikender Singh","family":"Yadav","sequence":"first","affiliation":[{"name":"Division of Periodontics Centre for Dental Education and Research, All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vandana","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Periodontics Centre for Dental Education and Research, All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrita","family":"Chawla","sequence":"additional","affiliation":[{"name":"Division of Conservative Dentistry and Endodontics Centre for Dental Education and Research, All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitesh","family":"Tewari","sequence":"additional","affiliation":[{"name":"Division of Pedodontics and Preventive Dentistry Centre for Dental Education and Research, All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renu","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics Surendera Dental College and Research Institute  Sriganganagar Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,20]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"377","article-title":"Correction of a large periradicular lesion and mucosal defect using combined endodontic and periodontal therapy: a case report","volume":"15","author":"Tseng CC","year":"1995","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-9657.1996.tb00106.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.4805397"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2018.07.014"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.2209\/tdcpublication.2017-0030"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2014.11.020"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2591.2008.01463.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0099-2399(79)80082-5"},{"key":"e_1_2_7_10_1","first-page":"125","article-title":"Surgical intervention of mucosal fenestration in a maxillary premolar: a case report","volume":"35","author":"Ju YR","year":"2004","journal-title":"Quintessence Int"},{"key":"e_1_2_7_11_1","first-page":"137","article-title":"The treatment of fenestrated root: case reports","volume":"9","author":"Ling LJ","year":"1989","journal-title":"J Dent Sci"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2591.1983.tb01301.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2009.06.012"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cap.10094"},{"key":"e_1_2_7_15_1","first-page":"425","article-title":"Isolated mucosal fenestration with localized gingival recession: closure with an acellular dermal graft. 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