Facial Aesthetics Research Articles

Le Fort I and nasal fracture, primary reduction, and secondary revision saddle nose: A case report

Maxillofacial trauma is a common clinical situation in emergency rooms. Lesions involving the maxillofacial complex pose a significant public health challenge, not only due to their costs but also because of the potential functional and aesthetic issues that patients may experience. While some fractures are more suitable for delayed treatment, others necessitate immediate attention, requiring intervention within 24 hours of the trauma occurrence. Different types of reduction and fixation exist depending on the patient’s age, location, type of fracture, and the surgeon’s preferences. We reported a case of a 20-year-old female patient diagnosed with Le Fort I bilateral fracture and closed nasal fracture followed by saddle nose. The patient was managed with open reduction internal fixation and closed reduction nasal bone. The saddle nose in the patient was managed four months later by augmentation rhinoplasty with rib cartilage and pearl fat graft. Proper management of Le Fort I fracture and nasal fracture accompanied with saddle nose by open reduction internal fixation and augmentation rhinoplasty with rib cartilage and pearl fat graft can restore occlusion and improve symmetrical, proportional facial aesthetics, which is the indicators of a successful holistic maxillofacial trauma management.

Facial Soft Tissue Characteristics Among Sagittal and Vertical Skeletal Patterns: A Cone-Beam Computed Tomography Study.

Background Facial esthetics depend on the skeletal and dental structures underlying variable facial soft tissue thickness. In this social context, determining the relationship between external soft tissue and underlying skeletal and dental hard tissue is essential for detailed orthodontic diagnosis and treatment planning. Objective This study aims to measure facial soft tissue thickness in different sagittal and vertical skeletal patterns. Methodology This is an observational study utilizing pre-existing cone-beam computed tomography (CBCT) images of 170 subjects (110 females and 60 males) with a mean age group of 37.45 ± 13.83 years. CBCT images were then classified sagittally based on the point A-Nasion-point B (ANB) angle from Steiner's analysis into skeletal Class I, Class II, and Class III. Furthermore, vertical patterns were grouped based on the Frankfort-mandibular plane angle (FMA) from Tweed's analysis into hyperdivergent, hypodivergent, and normodivergent facial types. One-way ANOVA was used to compare the means of facial soft tissue thickness between the skeletal groups, followed by Tukey's post-hoc test for individual comparison. Multinomial logistic regression analysis was used to test the association between gender, age, and skeletal groups. The significance level was 0.05. Results One-way ANOVA revealed statistically significant differences in both sagittal and vertical groups (p≤0.05).Tukey's post hoc analysis showed that the skeletal Class III group has increased soft tissue thickness in the subnasale, upper lip, and mention compared to Class I and Class II subjects. Moreover, the hypodivergent group demonstrated increased soft tissue thickness in gnathion and mentioned landmarks in relation to the other groups. Multinomial logistic regression analysis showed significant differences between groups according to both gender and sagittal skeleton patterns (p≤0.05), with males less likely to be in Class II. Conclusions Skeletal Class III and hypodivergent groups have thicker soft tissue in specific facial landmarks. Sexual dimorphism was marked in soft tissue measurements.

HIGH DENSITY POROUS POLYETHYLENE FACIAL IMPLANTS (PPAD) IN OROFACIAL HARMONIZATION

This work constitutes a literature review that explores the significance of Orofacial Harmonization Procedures (OHP) utilizing High-Density Porous Polyethylene Facial Implants (HDPE) to enhance facial aesthetics, contouring, rejuvenation, and volume augmentation. The paper addresses both theoretical and practical aspects of these procedures, providing insights into surgical technique, anatomy of treated areas, pre-operative assessment, anesthesia, pharmacology, medication, post-operative care, and potential complications. The review underscores the role of facial aesthetics in forming initial impressions and how aesthetic dental procedures within OHP are gaining popularity to achieve such harmony. It also emphasizes the integration of positive psychology in understanding aesthetic procedures, considering the positive psychological impacts on patients’ self-esteem and confidence. The work comprehensively discusses the use of HDPE as an alloplastic material for facial implants, elucidating its attributes such as the porous structure enabling implant vascularization and incorporation, along with its superiority over other materials in terms of inflammation and durability. Practical aspects of performing these procedures are addressed, encompassing commonly treated areas (chin, jaw, cheek), incision and suture techniques, anesthesia selection, antibiotic administration, and pre- and post-operative care. Furthermore, potential complications are presented, including improper patient selection, edema, infection, migration, extrusion, and others. The study highlights the significance of proper patient selection, surgical technique, and post-operative care for successful HDPE facial implant procedures. The review concludes that this technique can yield significant benefits in enhancing patients’ self-esteem and appearance, yet underscores the importance of adequate professional training and rigorous monitoring to prevent complications.

Gingival Pigmentation Features in Correlation with Tooth and Skin Shades: A Cross-Sectional Study in a Saudi Population.

The present study aimed to observe the anatomical distribution of gingival melanin pigmentation and evaluate its intensity and extent in different age groups and in correlation with skin and tooth shades. The participants of this study were 391 patients attending the Dental University Hospital. The presence of gingival pigmentation was assessed using De Krom's Oral Pigmentation Chart and its intensity was assessed using the Dummett-Gupta Oral Pigmentation Index. Skin colour and tooth shade were measured using the Fitzpatrick scale and the VITA classical shade guide, respectively. Statistical analyses included descriptive statistics and Pearson's Χ2 test for the association between the study variables. The prevalence of gingival pigmentation among the sample size was 74.4%, and pigmentations were present on both arches in 57.6% (n = 224) of the participants. The extent (category 1) was highest when pigmentation was evident in both arches, with category 4 being the least extent. Age and sex did not show a correlation with gingival pigmentation. Gingival pigmentation intensity was mild when pigments were present in one arch (p < 0.00), whereas it was heavy when both arches presented with gingival pigmentation. Medium brown colour and tooth shade A1 were the most common among participants with gingival pigmentation (p < 0.00). The association between gingival pigmentation intensity and extent in relation to skin colour was statistically significant (p < 0.00), as was tooth shade (p < 0.05). Gingival pigmentation is highly prevalent in the Saudi population, with different severity and extent levels. The effect of gingival pigmentation on smile and overall facial aesthetics should be considered when providing dental and cosmetic treatments.

Different managements for surgical approaches in the aesthetic and functional treatment of type IB altered passive eruption

Aesthetics has been one of the most discussed and explored subjects in today’s dentistry. Therefore, the search for procedures aimed at facial harmonization has been more frequent in dental offices. The gingival smile is characterized by excessive gingival exposure to the smile being one of the main complaints of the patients who seek a dental surgeon in order to obtain facial aesthetics, being able to present different causes. It is extremely important to correctly diagnose each case so that the correct etiology is stable and successful in the treatment to be performed. Objective: In the present paper, two clinical cases of patients with complaints of gingival smile and short teeth were reported in which the etiology of both was type IB altered passive eruption. Case report: Due to the individual characteristics of each patient, each case was solved with different surgical approaches. In the first case, the patient had a thick periodontium and therefore the clinical crown lenghtening procedure was performed through the internal bevel gingivoplasty with osteotomy and osteoplasty. In the second case, the patient had a thin periodontium, and it was possible to perform a clinical crown lenghtening using the flapless technique. Conclusion: Therefore, although both cases present the same etiology, different periodontal surgical techniques were used, which allowed for satisfactory results for the patients.

Class II Division 1 Malocclusion Treated with Two-Phase Orthodontic Approach

Enhancing facial aesthetics is a primary motivation for individuals with class II division 1 malocclusion seeking orthodontic treatment. Among the different techniques available to treat Class II malocclusions, a two-phase approach involving functional jaw orthopedics and fixed orthodontic treatment is commonly employed. In this case report, we present the treatment of a young male patient with a Class II Division 1 malocclusion. In the initial phase, the patient underwent growth modification and correction of overjet, overbite, and profile using the Andresen activator. Subsequently, a fixed orthodontic appliance was utilized in the second phase to achieve well-aligned arches and enhance both aesthetics and functionality.

Fat Grafting Reduces Skin Hyperpigmentation of Localized Scleroderma Patients: A Prospective Self-controlled Study.

Localized scleroderma (LS) is characterized by skin fibrosis, hyperpigmentation and soft tissue atrophy. Fat grafting has been widely used to correct LS deformity. To investigate the effect of fat grafting on the skin pigmentation of LS lesions. A prospective self-controlled study was conducted. Skin melanin and erythema indexes were measured by Mexameter® MX18 before and 3months after surgery. Differences between lesions and contralateral normal sites were compared to evaluate changes induced by fat grafting. Localized Scleroderma Cutaneous Assessment Tool and PUMC Localized Scleroderma Facial Aesthetic Index were used for clinical evaluation. Fourteen frontal linear LS patients participated in the study. Before surgery, the melanin index of the lesions was significantly higher than the contralateral sites (p = 0.023), while the erythema indexes were not significantly different (p = 0.426). Three months post-operation, the melanin index of the lesions significantly decreased (p = 0.008). There was no significant change in the erythema index of the lesions before and after fat grafting (p = 0.322). The LoSCAT and PUMC LSFAI scores demonstrated improved disease condition and facial esthetics after surgery. Fat grafting could alleviate skin hyperpigmentation and skin damage of LS lesions while having little effect on skin erythema and disease activity. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Filler Migration after Facial Injection—A Narrative Review

Background: The injection of dermal fillers for facial esthetics has become a very popular procedure. Although usually safe in the hands of the experienced user, filler injections may bear a risk of unwanted side effects. Material and Methods: This is a narrative review of dermal filler migration after facial injections. We performed research on the literature on Pubmed and Google Scholar. Inclusion criteria were observational studies, case reports, and clinical trials which investigated the association of facial filler injections to filler migration. Animal studies have not been considered. Intravascular injections were excluded. Results: We identified 28 reports that met the inclusion criteria. The age range of affected patients was 21 to 86 years (mean ± standard deviation: 47 ± 14.8 years). Women were 25 times more reported than males. Hyaluronic acid and polyalkylimide were the most commonly encountered filler substances. Injections into the nose, lips, nasolabial folds, and forehead (including glabella) are more often reported for filler migration than injections into the cheeks. Tear-trough correction bears a risk for orbital migration. The delay from injection to presentation of filler migration was highly variable. Very late filler migration was more commonly seen with permanent fillers than non-permanent products. Conclusions: Filler migration distant from the injection site can occur even several years after the primary treatment. All filler types can be involved. Permanent fillers bear a higher risk of very late filler migration. Migration of permanent fillers needs surgical treatment, while HA fillers respond to hyaluronidase injections. Detailed knowledge of facial anatomy, safer injection techniques, and filler qualities are preventive measures.

Anterior open bite treatment using Balters class II bionator: a case report

There are several reasons for the onset of malocclusion, which promotes disharmonious development of the craniofacial structure and may involve various factors such as incorrect positioning of teeth, maxilla, mandible, lips, tongue, and/or cheeks, possibly accompanied by deleterious oral habits. Malocclusion is a common finding that affects facial aesthetics, smile, as well as masticatory and respiratory functions, occurring in a large portion of the world’s population. Hence, a correct and early diagnosis is necessary for malocclusion treatment. There are various available treatments aiming for early correction of malocclusions. This clinical case report will describe a possible treatment for correcting an anterior open bite during the mixed dentition associated with a deleterious oral habit. The Balters’ Bionator is a functional orthopedic dento-muco-supported appliance that harmonizes the muscles of the tongue, lips, and cheeks, and treats skeletal discrepancies. At the end of this orthopedic treatment stage, the patient achieved the objectives of this work and will continue her care in a pediatric dental clinical setting at the Federal University of Amazonas-UFAM for further analysis and additional dentomuco-skeletal corrections.

Does different vertical position of maxillary central incisors in women with different facial vertical height affect smile esthetics perception?

BackgroundThe aim of this study was to assess the esthetic perceptions of orthodontists, prosthodontists and laypersons with regard to different vertical positions of the maxillary central incisors related to lateral incisors for different facial vertical height cases.Subject and methodsFrontal full-face photographs showing social smiles of three adult women aged between 18 and 25 years were used. Vertical position of the maxillary central incisor was changed (intruded or extruded) with 0.5 mm increments according to the reference gingival line resulting five images for each woman in a full-face view yielding a total of 15 images. A visual analog scale was placed below each smile to allow the raters to evaluate the attractiveness of each smile independently. One-way analysis of variance was used to determine whether there was a difference between more than two independent groups in terms of quantitative variables. Comparisons of more than two dependent groups were examined with repeated measures one-way ANOVA. The significance level was taken as 0.05 for all analyses.ResultsFor increased facial vertical height, the highest scores for orthodontists were given to the 0.5 mm extruded (64.18 ± 26.36), for prosthodontists to the control (57.28 ± 19.80), and for layperson to the 1 mm extruded (61.27 ± 25.98) central incisor position. For decreased facial vertical height, the highest scores were obtained at the 0.5 mm intrusion with an increasing pattern from orthodontists to laypersons (63.95 ± 22.08 for orthodontists, 79.87 ± 21.43 for prosthodontists, and 79.88 ± 19.17 for laypersons). All three rater groups gave the highest scores to the 0 mm (control) smile design for normal facial vertical height. When these scores were compared among the groups, laypersons gave significantly higher scores compared to orthodontists (p < 0.001) and prosthodontists (p = 0.005).ConclusionsThe facial vertical height significantly affected the perception of smile esthetics. Keeping the distance between the central and lateral incisors longer than 1 mm in individuals with increased facial height may be important in terms of increasing patient satisfaction in terms of clinical aesthetics. On the contrary, keeping the distance between the central and lateral incisors shorter than 1 mm may create a more esthetically acceptable result in individuals with short facial height.

Skeletal Class II Malocclusion: From Clinical Treatment Strategies to the Roadmap in Identifying the Genetic Bases of Development in Humans with the Support of the Collaborative Cross Mouse Population.

Depending on how severe it is, malocclusion, which may involve misaligned teeth, jaws, or a combination of the two, can hurt a person's overall facial aesthetics. The maxillary molar develops before the mandibular molar in class II malocclusion, which affects 15% of the population in the United States. With a retrusive mandible, patients typically have a convex profile. The goal of this study is to classify the skeletal and dental variability present in class II malocclusion, to reduce heterogeneity, present the current clinical treatment strategies, to summarize the previously published findings of genetic analysis, discuss these findings and their constraints, and finally, propose a comprehensive roadmap to facilitate investigations aimed at determining the genetic bases of malocclusion development using a variety of genomic approaches. To further comprehend the hereditary components involved in the onset and progression of class II malocclusion, a novel animal model for class II malocclusion should be developed while considering the variety of the human population. To overcome the constraints of the previous studies, here, we propose to conduct novel research on humans with the support of mouse models to produce contentious findings. We believe that carrying out a genome-wide association study (GWAS) on a large human cohort to search for significant genes and their modifiers; an epigenetics-wide association study (EWAS); RNA-seq analysis; integrating GWAS and the expression of quantitative trait loci (eQTL); and the testing of microRNAs, small RNAs, and long noncoding RNAs in tissues related to the skeletal class II malocclusion (SCIIMO) phenotype, such as mandibular bone, gum, and jaw in humans and the collaborative cross (CC) mouse model, will identify novel genes and genetic factors affecting this phenotype. We anticipate discovering novel genetic elements to advance our knowledge of how this malocclusion phenotype develops and open the venue for the early identification of patients carrying the susceptible genetic factors so that we can offer early prevention treatment strategies.

Customized planning of the visible maxillary arch width in harmony with interparopia width and smile width for female facial aesthetics.

The visible maxillary arch width (VAW) is an important aesthetic-determining feature. To date, there is no well-established methodology to determine the aesthetically optimal VAW in customized treatment planning. In this study, the common traits of the dentofacial configuration were investigated in most attractive Asian and Caucasian female smiles. The smiling photo of a subject was digitally modified based on combined variations of VAW, smile width (SW), transverse facial dimensions (TFD), and vertical facial dimensions. These modified photos were assessed for aesthetics. The aesthetically essential parameters were identified, and their mathematic correlations and reference ranges were determined for different vertical facial patterns. Using the obtained results, a mathematic guidance was constructed for customized smile designing. The applicability of this guidance was tested in Asian females. The most attractive Asian and Caucasian female smiles have intraracial and interracial commonalities in the VAW-to-TFD ratios. The interparopia width (IPD) predominated over facial widths in determining well-matched VAW and SW. For optimal smile aesthetics, the VAW and SW were correlated as simulated by the formula 1.92 IPD ≤ VAW + 2.3 SW ≤ 2.17 IPD, plus the VAW-to-IPD ratio within 0.54 to 0.62 and the SW-to-IPD ratio within 0.61 to 0.71, ranges tailored to vertical facial patterns. This constitutes a mathematic guidance for customized planning of the aesthetically optimal VAW. This guidance was preliminarily validated to be applicable to Asian females. The VAW-to-TFD ratios were essential for Caucasian and Asian female smile aesthetics. The mathematic guidance could serve as a reference for customized smile designs for Asian females.

Demographic of orthognatic cases seen in Kulliyyah of Dentistry IIUM

Orthognathic treatment is a combination of orthodontics and surgery, aimed to restore functional occlusion and the facial aesthetics. KOD orthognathic team has been established since 2018. There was no published demographic profile of the orthognathic patients referred. This study aimed to enumerate the demographic data and correlations for the orthognathic cases seen in KOD, IIUM from 2018 until December 2020. A total of 28 patients were referred for consultation. One patient was excluded as no referral letter was attached. Data were obtained from patients’ case notes, photos and study models. Data collected were then categorized into patients’ demographic profiles, clinical features, patients’ psychological status and treatment. The demographic pattern and correlations were analysed using SPSS version 25.0. Out of 27 patients, most patients were females (66.7%), Malay (55.6%) and within the age group of 21 to 30 years old (44.4%) and originated from Pahang (88%). Majority of patients presented with Class III skeletal base discrepancy (66.7%), facial asymmetry (76.0%), increased vertical dimension (51.9%), shifted chin point (83.3%), Class III incisal relationship (70.4%), reversed overjet (70.4%), reduced overbite (56.0%) and crossbite (77.7%). Significant relationships were found between skeletal base discrepancy with incisal relationship, overjet, crossbite, canine relationships and right molar relationship. 57.1% agreed to orthognathic surgery, 32.1% opted for orthodontic treatment alone whilst 10.7% refused any treatment. It is hoped that this baseline demographic data may aid in the management and resource planning for this team in the future.

Carboxytherapy in esthetic medicine – A review

Carboxytherapy is a minimally invasive method used not only in esthetic medicine. It is defined as the transcutaneous or subcutaneous application of carbon dioxide gas. The treatment exerts effects on various levels including improvement of tissue oxygenation, vasodilatation, stimulation of fibroblasts, and antimicrobial activity. In this review, we will focus on facial and neck esthetics, localized adiposities and cellulite, and scars and stretch marks. We discuss reported evidence for these indications and safety issues. We also mention possible combinations with other treatments. In general, a repeated application is necessary to achieve desired results.

Review Article on the All-On-Four Treatment Concept in Dental Implants

Edentulism, a condition characterized by the absence of teeth, significantly impacts facial aesthetics, eating efficiency, and speech fluency, thereby diminishing the quality of life. This paper aims to explore the All-On-Four Treatment Concept in Dental Implants, a promising solution to this issue. The All-On-Four approach, though complex, offers a pathway to restore smile and functionality by using four strategically positioned implants to hold a temporary prosthesis. This prosthesis is later replaced by a permanent version after approximately four months. This swift oral restoration technique significantly enhances a patient’s self-confidence and overall life quality. The significance of this treatment lies in its potential to provide a less invasive and more affordable solution for severe jawbone atrophy, where the proximity of critical anatomical structures and compromised bone conditions may hinder other prosthetic solutions. The paper concludes with a discussion on the potential of the All-On-Four treatment to revolutionize dental implant procedures, offering a beacon of hope for individuals suffering from edentulism.

The efficacy of the dental Water Jet, orthodontic, and conventional toothbrushes in plaque removal around orthodontic braces in adolescents: A randomized controlled trial.

Orthodontic treatment improves both masticatory function and the aspects of facial esthetics through the correct alignment of the teeth. If oral hygiene is neglected during fixed orthodontic treatment, it may lead to plaque accumulation and gingivitis. The aim of this randomized controlled trial was to evaluate the effectiveness of the dental Water Jet (DWJ), and orthodontic toothbrush (O-TH) in removing dental plaque around the orthodontic braces compared to conventional toothbrush (C-TH) in adolescents. This was a three-arm, double-blind, and parallel-group randomized active-controlled trial. Forty-five patients were randomly allocated into three groups: DWJ, the O-TH, and the C-TH (control group). The primary outcome measure was dental plaque accumulation change from the baseline (t0 ) to post-cleaning (t1 ), and plaque scores were recorded using the Orthodontic Plaque Index (OPI). The current clinical trial was registered and approved by Australian New Zealand Clinical Trials Registry (ACTRN12623000524695). A statistically significant difference was noted in the OPI scores between different time points in the DWJ group, the O-TH group, and the C-TH group (p < .05). However, no significant difference was noted between the groups after the cleaning procedure (p > .05). The level of oral hygiene was not satisfactory in patients undergoing fixed orthodontic treatment. In addition, the efficacy of the DWJ was not superior to O-TH nor to C-TH in plaque removal.

“Critical” values of parameters of facial profile esthetics

Objective. To carry out the expert assessment of the facial profile esthetics with transformation of angular parameters beyond the normal values. Materials and methods. The expert analysis enclosed 22 independent orthodontists (11 men, mean age 36.8 1.2 years; 11 women, mean age 35.3 2.2 years) using graphic schemes of male and female facial profiles with changed angular parameters. Results. It was established that the changed angular parameters of the facial profile beyond the borders of the referent intervals negatively influence the assessment of attractiveness of the profile. The analysis of expert evaluation curves detected the values, with which the facial profile is perceived as an unattractive: the profile angle in men 164 and 182, in women 160 and 178; the convexity angle of the face in men 16 and 2, in women 14 and 2; the nasolabial angle in men 120 and 70, in women 115 and 70; the mentolabial angle in men 150 and 90, in women 150 and 95; the convexity angle of the lips in men 150 and 85, in women 150 and 105; the nasofacial angle for both sexes 45 and 20. There exist also critical values of parameters, on reaching which the further change in the latter does not lead to the change in expert evaluation of extremely unattractive profile. Conclusions. When evaluating the facial profile esthetics, it is necessary to orientate oneself to the degree of deviation of parameters from the mean values taking into account the gender dimorphism. The presence of parameter with critical value has an extremely negative effect on the profile esthetics, which is characterized as extremely unattractive irrespective of the values of other parameters.

Hard and Soft Tissue Relapse After Different Genioplasty Procedures: A Scoping Review.

The chin is a crucial component of facial aesthetics, and 20% of craniofacial problems require repair of the chin size, shape, and position. Genioplasty is used to treat irregularities in all three planes of the chin. Specific hard and soft tissue relapses following various genioplasty techniques have not been adequately studied in the literature to date. The purpose of this scoping review was to investigate the stability of hard and soft tissue changes achieved by different genioplasty procedures, six months after the procedure. A literature search was performed on PubMed, Web of Science, Embase, Wiley Online, Scopus, Google Scholar, Science Direct, and Cochrane databases from January 1, 2011to October 31, 2022. Prospective and retrospective cohorts, case-control studies, observational studies, and randomized control trials, with at least 10 patients, which were written in English and evaluated the stability of different genioplasty procedures, with a follow-up period of at least six monthswere included. The manual and electronic search yielded 523 articles, and after complete screening, seven articles were selected (five with advancement genioplasty and two with reduction genioplasty) that met the eligibility criteria for review. The patients undergoing reduction genioplasty had a mean age of 24.15 years, compared to 20.5 years for augmentation genioplasty. The average follow-up period was 18.64 months for augmentation genioplasty and 10.5 months for reduction genioplasty technique. The relapse was assessed at pogonion, and it was noted that the average surgical advancement at hard tissue pogonion was 7.04 mm with a relapse of 0.69 mm after six months post-treatment. The average vertical movement of the hard tissue pogonion was 1.8 mm with a relapse of 0.74 mm. The average reduction at hard tissue pogonion was 3.2 mm in the vertical direction with a relapse of 0.2 mm and 0.8 mm reduction in soft tissue pogonion with a relapse of 0.3 mm. The soft to hard tissue ratio mentioned in the different studies ranged from 0.89 to 0.97. Both reduction and augmentation genioplasty are stable and reliable for altering the chin position for aesthetic purposes. The recommended mode of fixation is rigid fixation.

Action of Platelet-Rich Plasma in Facial Esthetics and its Recovery

Platelet-rich plasma (PRP) is prepared by using autologous blood plasma enriched with platelet. PRP has been proven to be a successful analog to correct blood loss during cardiac surgery and cardiothoracic bypass. Some authors have demonstrated bone regeneration following tooth extraction with healthy compact bone by using PRP. Typical protocols include either 1 or 2 centrifugation steps to separate whole blood into 3 layers: a top plasma layer, middle leukocyte layer, and bottom red blood cell layer, to collect a concentrate of platelets in plasma. The rationale for use and therapeutic potential of a high concentration of platelets is based on their capacity to supply and release supraphysiologic amounts of essential growth factors and cytokines from their alpha-granules to provide a regenerative stimulus that augments healing and promotes repair in tissues with low healing potential.

Amelioration of Pathological Tooth Migration by Surgical Periodontal Therapy Alone: A Stupendous Clinical Case Report with Two Year Follow up

Moderate-to-severe form of periodontitis is often accompanied by pathological tooth migration. This is characterized by spacing and proclination of teeth. Patients often feel awkward regarding their facial esthetics and seek treatment for the same. Pathological tooth migration is a complex puzzle with various etiological factors to its credit. Treatment often involves time-consuming interdisciplinary approach. Very few case reports have achieved complete resolution of pathological tooth migration by periodontal therapy alone. In this unique case report, periodontal therapy alone could ameliorate pathological tooth migration. Further to it, results are stable for 2 years and continue to be so. Hence, meticulous periodontal therapy is effective in the management of pathologic tooth migration.