In addition to that, surgery-associated tissue injury leads to an inflammatory reaction accompanied by increased production of proinflammatory cytokines, which can induce peripheral and central sensitization with a failed nociception system, leading to pain augmentation. Buccal exostoses occur as bilateral, smooth bony growth along the facial aspect of the maxillary and/or mandibular alveolus. Replacing a Defective Dental Bridge with Dental Implants? Routine post-operative instructions are given to the patient and occasionally antibiotics may be prescribed. Prevalence of Palatal Exostoses in Patients Who Have Received Periodontal Surgery in the Posterior Maxilla. WebTotal time 1h, some pain afterwards for 2-3 days, easily manageable with regular pain meds. Be sure to see your dental professional for regular cleanings not only to keep your teeth pearly white and bacteria-free but also to have them check on the health and size of any hard bony lumps on your gums. 3, pp. After 3 months from surgical operation we performed an MRI of the facial skeleton and we appreciated a soft tissue volume increase in the area of previous fat grafting (Figure 4). 3, pp. WebThe type of exostosis you have depends on its location in your mouth. official website and that any information you provide is encrypted The case reported showed a positive final outcome. Moving from these evidences we consider autologous fat grafting as an innovative solution for pain syndromes related to scar retraction although the exact mechanism of action is still unclear. P. Gaetani, M. Klinger, D. Levi et al., Treatment of chronic headache of cervical origin with lipostructure: an observational study, Headache, vol. Dental panoramic tomography and cone beam tomography can be used to confirm diagnosis. Exostoses have been described as nodular protuberances of mature intraoral bone. Background. FOIA Following Colemans procedure [11], the obtained fat was processed by centrifugation at 3000rpm for 3 minutes. When removal is indicated, proper diagnosis, planning, and technique should be used for optimal results. The https:// ensures that you are connecting to the Idk how i feel about surgery lol but i'll talk to my ortho more about my concerns to get all options. TM, if very large, can inhibit proper speaking, and all types of exostosis can interfere with denture placement. The psychosomatic disorders pertaining to dental practice with revised working type classification. Buccal exostoses generally occur bilaterally. FOIA This community provides (unofficial) support for those using Invisalign! 42794295, 2002. Advances in dental lasers and their ability to penetrate hard tissues have shown promise for a more efficient and less invasive option, reports Dentistry Today. A. M. Botman et al., The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation, Plastic and Reconstructive Surgery, vol. Bookshelf Buccal exostosis is a bony overgrowth located on the outer side of the maxilla that is facing the cheek superior to the teeth. Fig. The patient also stated that he had difficulty in placing and removing his RPD, and had trouble with food impaction below the buccal exostosis. Careers. and transmitted securely. I don't know what could even be done to start dealing with this or if it's just something i'll have to deal with forever even though i've sunk $6000 into invisalign. 24, no. government site. They tend to appear in early adolescence and may very slowly increase in size with time. Yes for me i would say it's more aesthetic - I wanted to do invisalign for aesthetic purposes overall because my teeth weren't too bad when i started and i just wanted to straighten them out + fix my slight overjet so it's a bit disheartening to now come out with a problem i didn't even consider. Im on try 7 of 17. More refinements to target this? 1998. If they notice thickened or protruding bone during their structural assessment, they will likely take a photo or measure the structure to document any growth that occurs over time. Medically Reviewed By Colgate Global Scientific Communications. While your exostosis may have seemed at first like a cause for alarm, hopefully, you now know that they tend to be completely harmless. At the same time, malocclusion can also cause pain and discomfort. Discussion. No support therapy has been described until now for these weakening symptoms in this group of patients who, most of the time, are analgesic medications dependent. At completion of the procedures, flat buccal bone ridges with a clear esthetic improvement were observed. 11301131, 2010. 2014 Jan;27(1):16-22. doi: 10.3344/kjp.2014.27.1.16. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Yeah, they really have a lot of bunnies in their hats he also performed another surgery 8600 Rockville Pike Oral Surg Oral Med Oral Pathol Oral Radiol Endod. A total of about 5 cc of adipose tissue was injected. F. Caviggioli, L. Maione, D. Forcellini, F. Klinger, and M. Klinger, Autologous fat graft in postmastectomy pain syndrome, Plastic and Reconstructive Surgery, vol. The surgical procedures, which were performed at separate appointments for the left and right sides, involved reflection of full-thickness flaps and careful osteotomy with a carbide spherical drill and a Rhodes chisel. The type of exostosis you have depends on its location in your mouth. During the clinical meeting we observed progressive release of scar retraction and quality improvement measured with POSAS scale [12], together with an important decrease of pain symptoms which lasts for all the postoperative follow-up controls (Figure 3). Epub 2013 Dec 31. 45, pp. [6] In addition, it is recommended that patients who present with multiple growths showing similar characteristics but not in the classic exostoses locations should be evaluated for Gardner syndrome.[7]. Buccal exostoses are broad-based, non-malignant surface growth occurring on the outer or facial surface of the maxilla and/or mandible, found usually in the premolar and molar region. 2007 Aug;19(3):423-33, vii. I had the same procedure for 90% aesthetic reasons, but above my six upper front teeth. Your dentist and dental hygienist can detect oral problems early and suggest the best treatments for you. WebBuccal exostoses are broad-based, non-malignant surface growth occurring on the outer or facial surface of the maxilla and/or mandible, found usually in the premolar and molar Clinical examination showed a postsurgical scar area of about 2cm in length, retracted and adherent to deeper planes just at the upper right of the vestibule, which causes pain at digital pressure. I feel like because of this, the right side of my smile also feels more pushed in compared to the left. Also, if you have missing teeth and are considering dentures, all types of exostosis can potentially interfere with the placement of your artificial teeth. We subsequently treated her with autologous fat grafting according to Colemans technique. 2000 Jun;71(6):1032-42. doi: 10.1902/jop.2000.71.6.1032. Moreover the patient declared that she stopped analgesic drug assumption immediately after operation. Unable to load your collection due to an error, Unable to load your delegates due to an error. Buccal exostoses generally tend to be asymptomatic and are usually painless. Floss or clean between your teeth with interdental brushes or water flossers at least once a day, and use antimicrobial mouthrinses and tongue scrapers. Our team adopts autologous fat grafting in the treatment of multiple pathological status beyond all scar treatment and pain syndromes. I noticed in December and freaked out that it was Cancer or something?! It could be hypothesized that fat grafting could inhibit inflammation and determine pain reduction and analgesia. Gum contouring? Buccal exostoses are hard bony protrusions on the outside of your gums and are less common. Using local anesthesia (numbing the specific area around a surgical operation), the surgeon will make an incision and lift the soft tissue away to expose the overgrowth. Both informed consent form and preoperative images were collected (Figure 1). 2020 Jul 14;8(7):2325967120932101. doi: 10.1177/2325967120932101. There are rare circumstances when exostoses have interfered with oral function or denture placement and have required surgery, but that is not the norm. The protruding bump can be irritated by the process of chewing and swallowing food which can result to an open sore on roof of mouth. In these advanced cases surgical treatment is needed to remove bony prominences and to restore oral function and contour. Buccal alveolar exostoses: prevalence, characteristics, and evidence for buttressing bone formation. Most often, by practicing good oral hygiene, your mouth can be as healthy as if you had no exostoses at all. [9] They are strongly associated with the presence of torus mandibularis and torus palatinus.[9]. We can appreciate soft tissue volume deposition in the area of previous fat grafting. The procedure is also sometimes called a cheek reduction. HHS Vulnerability Disclosure, Help Buccal exostosis: (A) Maxillary anterior, Fig. Patients should be reassured that these growths are benign and should be encouraged to maintain good oral Palatal exostoses are found on the palatal aspect of the maxilla, and the most common location is the tuberosity area. Intraoral Clinical Picture of First patient showing maxillary buccal exostoses. More commonly seen in the maxilla than the mandible, buccal exostoses are considered to be site specific. WebThey begin to develop in early adulthood and may very slowly enlarge over years. After routine preoperative examination and clinical assessment, the patient underwent liposuction under sedation and local anesthesia. If there is neither pain nor sensitivity, the buccal exostosis simply needs to be monitored with routine dental check-ups. Press question mark to learn the rest of the keyboard shortcuts. [11] The mass is generally smooth although in some cases a sharp, bony prominence may be present resulting in tenderness beneath the mucosa. WebExostosis or hyperostoses are localized cortical bone growth on the mandible and maxilla. The fat graft was injected using an 18-gauge angiographic needle with a snap-on wing (Cordis, a Johnson & Johnson Company, NV, Roden, Netherlands) under mucous membrane in the scar area at the upper right vestibule (Figure 2). Exostoses are protuberances of calcified bone which are designated according to typical anatomic location. These clinical entities could become invalidating for patients especially when they reach such a volume to interfere with feeding and speaking or to alter facial mimic and contour. Please enable it to take advantage of the complete set of features! 118, no. If you're experiencing abnormal bone growth in your mouth, you have what's called an exostosis. Thrower's Exostosis of the Shoulder: A Systematic Review With a Novel Classification. The term sounds a little frightening, but don't worry in most cases, these growths aren't a cause for any concern at all. Material and Methods. Surgical management of the bilateral maxillary buccal exostosis. The overlying mucosa appears to be stretched but intact and normal in color. Feeling really sad and unoptimistic right now about what's waiting for me at the end of the invisalign journey. Federal government websites often end in .gov or .mil. How are you handling it now? Commonly found to appear in the premolar-molar region. The site is secure. Clinical assessments were performed at 5 and 14 days, 1, 3, and 6 months, and 1 year after surgical procedure. WebTorus and exostosis are bone growth anomalies commonly found on the palate (known as palatine torus), inside of the lower jaw bone ( mandibular torus ), and outside of either the 465469, 2008. Concurrence of torus palatinus with palatal and buccal exostoses: case report and review of the literature. Buccal Exostosis: Causes, Treatment and Care | Colgate. M. Klinger, F. Caviggioli, F. Klinger, A. V. Pagliari, F. Villani, and V. Bandi, Scar remodeling following burn injuries, in Fat Injection: From Filling to Regeneration, S. R. Coleman and R. F. Mazzola, Eds., Quality Medical Publishing, St. Louis, Mo, USA, 2009. We observed a progressive release of scar retraction together with an important improvement of pain symptoms. They are more common in males than females, occurring in a ratio of about 5:1. MeSH eCollection 2020 Jul. She did not assume any other medications. WebBuccal fat removal is a surgery to remove the fat in this area of your face. -, Shamim T. The psychosomatic disorders pertaining to dental practice with revised working type classification. The case described widens the possible application of autologous fat grafting on a new anatomical site as buccal vestibule and in one specific clinical setting confirming its promising biological effects. Diagnosis: A CBCT (cone beam CT scan) is required for the assessment of torus / exostosis size, proximity of teeth, anatomy of the jaw bone, and vital structures such as nerves and sinuses. However, they can enlarge gradually over time in response to bone apposition related to direct physical irritation during eating. Postsurgical scar retraction should be mentioned together with pain sensation during chewing, which can compromise dramatically the quality of life of patients. Here are several before and after examples: Dr. H Ryan Kazemi is a board-certified oral and maxillofacial surgeon in Bethesda, MD. doi: 10.7759/cureus.29020. Surgical Procedures of Buccal Exostosis Resection on orangecountysurgeons.org During buccal exostosis resection, a benign bone Etiology is still not established, but it has been suggested that the bony overgrowth can be because of abnormally increased masticatory forces to the teeth. Supported by our promising results we approached with positive results also chronic headaches of cervical origin, both chronic cervicogenic and occipital neuralgia [10]. I'm currently on refinements for invisalign and one thing that has been bothering me throughout this process is that on my right side, my gums are continuing to become more raised and through google searches, i've found out this is called buccal exostosis. 3, pp. The prevalence of buccal In the rare instance where treatment is recommended, the exostosis can be removed in a dental specialist's office, usually by an oral surgeon. This bone will then be sent for histopathological examination to differentiate from benign to malignant neoplastic processes. An official website of the United States government. A buccal exostosis is an exostosis (bone prominence) on the buccal surface (cheek side) of the alveolar ridge of the maxilla or mandible. Removal of torus or exostosis is a relatively minor procedure with minimal discomfort. Advanced Search Coronavirus articles and preprints Search examples: "breast cancer" Smith J"breast cancer" Smith J The most commonly occurring bone growths are found in the mouth's roof (torus palatinus) and beneath the 16101615, 2013. Medsinge SV, Kohad R, Budhiraja H, Singh A, Gurha S, Sharma A. Buccal exostosis: a rare entity. Always seek the advice of your dentist, physician or other qualified healthcare provider. 53, no. Thanks for sharing your experiences, i appreciate it!!! M. Klinger, M. Marazzi, D. Vigo, and M. Torre, Fat injection for cases of severe burn outcomes: a new perspective of scar remodeling and reductio, Aesthetic Plastic Surgery, vol. [16] The patient will then be recalled after 1 week in order to remove the sutures and often after a few months for post-operative follow up. N. Pallua, A. Baroncini, Z. Alharbi, and J. P. Stromps, Improvement of facial scar appearance and microcirculation by autologous lipofilling, Journal of Plastic, Reconstructive & Aesthetic Surgery, vol. The .gov means its official. Nonetheless also surgical removal could be related to different drawbacks. 3, supplement, pp. The adipose tissue was harvested from the right flank, which is an easy accessible and abundant reservoir of adipose tissue. Youre beautiful girl! 507513, 2013. Boge, RDH, BS, MPA, E. (2019). Currently, buccal exostoses do not commonly require treatment. If there is neither pain nor sensitivity, the buccal exostosis simply needs to be monitored with routine dental check-ups. Patients are given oral hygiene advice and are advised to cleanse above and below the growth with a mouthwash once a day to remove any food debris. [14] They are benign and in most individuals they do not cause any problems. buccal cavity K13.79 Pain (s) R52 - see also Painful mouth K13.79 Palatoplegia K13.79 Paralysis, paralytic (complete) (incomplete) G83.9 uvula K13.79 palate K13.79 (soft) velum palati K13.79 Perforation, perforated (nontraumatic) (of) uvula K13.79 Sore mouth K13.79 Stomatorrhagia K13.79 [12] Initial presentation usually occurs in early adolescence and the lesions may slowly enlarge up to 34cm in diameter with time, however there is no malignant potential. Orthop J Sports Med. [Analysis of the effect of mesial implant position on surrounding bone stress of mandibular edentulous jaw under dynamic loads]. 528532, 2014. There is no known cause (etiology) of bone growing out of gums, the mouth's roof, or under the tongue. At the same time, malocclusion can also cause pain and discomfort. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Moving from these evidences, we decided to adopt autologous fat grafting for the treatment of postsurgical scar retraction and pain sensation related to exostoses surgical removal, in order to verify its possible beneficial effects in this new approach. As always, practice good oral hygiene by brushing at least twice a day. 10331037, 2014. Some people may want a growth removed due to aesthetic concerns. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. The https:// ensures that you are connecting to the 108S120S, 2006. 19, 20, 23 to 26, 28, and 30. There are, however, some occasions were treatment is required, for example; If the growth needs to be removed then a simple surgical procedure can be carried out under local anaesthetic with no recurrence in the long-term follow up. We hypothesize that autologous fat graft due to the regenerative role of the stromal fraction of adipose tissue grafted could promote a reorganization of fibrotic tissue together with soft tissue regeneration, leading to scar release and reducing nerve excitatory pattern with consequent positive clinical results on pain control. The diagnosis is established by a combination of medical history and clinical and radiographic features of the affected region. Up to now no support therapy has been described to treat these weakening symptoms in this group of patients. Giant Osteoma of Zygoma Mimicking Pseudo-Temporo-Mandibular Joint Ankylosis: A Case Report. Persistent pain as a consequence of surgical treatment has been reported for several common surgical procedures and represents a clinical problem of great magnitude. Funny enough, before my refinements the right was the side which was doing really well because my upper and lower teeth were aligned whereas the other side they were misaligned and needed more treatment. It's nothing more than a protrusion of bone in a roughly circular shape, which can develop on the upper or lower jaw bone. Clinically, buccal exostoses appear as single, broad-based masses, usually situated bilaterally in the premolar and molar region on the facial surface of the maxillary alveolar bone. Exostosis can cause chronic pain or irritation, depending on its size and location. Sometimes, cartilage will grow over an area of exostosis, which is called osteochondroma. These bony outgrowths often occur in the ear when they are called surfers ear, on the heel of the foot, or underneath the nail beds. Their tendency to grow in size may also contribute to periodontal disease as a result of food build up in the area of the lesion. The overlying mucosa appears to be stretched but intact and normal in colour. 62, no. It's common for people to have exostoses in their mouths for years before they even notice they are there. At first ortho said just ignore it , it's normal, so I did. Exostosis mouth is very rarely a concern for the dentist or patient. Another potential issue is that the tissue covering bone growths is very thin and could get scratched or injured from sharp food resulting in ulcer formation. Stitches were annoying, but otherwise the pain was manageable. Pictures above are flipped - the right side irl is showing to the left in the picture and vice versa. Before *Other aligner company users are also welcome, but refrain from advertising, Press J to jump to the feed. K. le Blanc, Mesenchymal stromal cells: tissue repair and immune modulation, Cytotherapy, vol. J Periodontol. The presence of buccal exostosis can be diagnosed by both clinical examination and radiological interpretation of the oral cavity. WebExostoses are bony protuberances that occur on the buccal aspect of the mandibular or maxillary alveolus (Figure 8). eCollection 2022 Sep. See this image and copyright information in PMC. F. Caviggioli, L. Maione, V. Vinci, and M. Klinger, The most current algorithms for the treatment and prevention of hypertrophic scars and keloids, Plastic and Reconstructive Surgery, vol. Surgical removal of the bony buccal exostoses is indicated if they cause pain and tenderness in the overlying mucosa or interfere with normal occlusal function. Do you have bony bumps in your mouth? An exostosis is a benign, localized, peripheral overgrowth of bone of unknown etiology. Found usually in the premolar and molar region. The mucosa overlying the buccal exostoses typically appears intact and is normal in color. Why buccal exostoses form is unclear,[8] but it may involve bruxism (tooth clenching and grinding),[8] and genetic factors. 3, pp. 126, no. J Int Oral Health. (a)-(b) MRI of the facial skeleton after 3 months from surgery. Also schedule regular dental visits. doi: 10.1016/j.coms.2007.04.003. 2017 Nov 9;52(11):672-677. doi: 10.3760/cma.j.issn.1002-0098.2017.11.005. Buccal exostosis or osteoma These are an abnormal growth of hard lump on the back roof of the mouth. Technique: This procedure is typically performed by an oral surgeon experienced in management of conditions related to jaw bone. Exostosis: Causes, types, and treatment - Medical News Today Oral Maxillofac Surg Clin North Am. Buccal exostoses occur along the buccal aspect of the maxilla or mandible, usually in the premolar and molar areas. In some circumstances, patients may develop traumatic ulcers and exposure of bone (known as dehiscence) leading to pain and discomfort. YYYY Colgate-Palmolive Company. In fact postsurgical scar retraction could determine chronic pain in oral region, in particular during chewing, with an overall reduction of patients quality of life. Palatal exostoses revealed a prevalence of 30% while buccal exostoses presented a prevalence rate of 0.9 per 1000 persons [13]. The surgeon will then trim the bone using a high-speed dental tool (or with new developments in technology, possibly a dental laser, according to Dentistry Today). An official website of the United States government. L. Maione, A. Memeo, L. Pedretti et al., Autologous fat graft as treatment of post short stature surgical correction scars, Injury, vol. Due to it being difficult to clean around the exostosis, periodontal disease can often occur as a result, and so this should be treated by t When being symptomatic, exostosis allows the possibility of surgical removal that could be related to different drawbacks. [13], An additional biopsy for diagnosis of buccal exostosis is not usually recommended, however it is important to rule out the possibility of early osteosarcomas and chondrosarcomas. Chandna S, Sachdeva S, Kochar D, Kapil H. J Indian Soc Periodontol. Concurrence of Torus Palatinus, Torus Mandibularis and Buccal Exostosis. 3. 1. Clinical history revealed a diagnosis of Sjogren syndrome and corrective surgery of cleft palate in 1996; no other pathologic conditions were present. The maxilla is shown to display a higher prevalence rate of 5.1:1 in comparison to mandible. 2007. [3], Buccal exostoses are bony hamartomas, which are non- malignant, exophytic nodular outgrowths of dense cortical bone that are relatively avascular.[5]. In fact our experience could open a new route of regenerative surgery addressing a mucosal tissue as buccal one. 6, pp. 559561, 2006. It may be a nodular, flat or pedunculated protuberance located on the jawbones alveolar surface.1 It frequently occurs in long bones where tendons and muscles are inserted. WebA torus is often obvious, presenting as several rounded protuberances or calcified multiple lobules, whereas a buccal exostosis is singular and may appear as a sharp, pointed bony Unauthorized use of these marks is strictly prohibited. 67, no. Moreover the patient revealed chronic assumption of analgesic medication (Ibuprofen 600mg) to control pain sensation. 2014;27:1622. WebBuccal exostoses (buttressing bone) appear as a bilateral row of smooth bony nodules along the facial alveolar process of the mandible and/or maxilla. No local or systemic signs of infection were found, and no complications occurred. If there is any diagnostic doubt, or the patient is anxious When the exostosis is covered with cartilage, it's called an osteochondroma. Most common types of intraoral osseous overgrowths are TP Accessibility The histologic features of exostoses are described as hyperplastic bone, consisting of mature cortical and trabecular bone [1]. Males also are afflicted more than females with a prevalence rate of 1.66:1, in all intraoral locations. Exostoses have been described as nodular protuberances of mature intraoral bone. On this Wikipedia the language links are at the top of the page across from the article title. Total time 1h, some pain afterwards for 2-3 days, easily manageable with regular pain meds. After collection of both clinical history and examination we proposed to our patient surgical scar tissue correction with autologous fat grafting. Unauthorized use of these marks is strictly prohibited. To keep the rest of your mouth healthy, brush twice daily with a toothpaste that repairs early teeth and gum damage. 2015;7:6264. S. R. Coleman, Structural fat grafting: more than a permanent filler, Plastic and Reconstructive Surgery, vol. Treatment is only necessary when the nodules interfere with the normal functions of the mouth or become an aesthetic concern for the patient. I'd do it again in a heartbeat. Exostosis or abnormal bone growth within the ear canal is called as Surfers ear. Clipboard, Search History, and several other advanced features are temporarily unavailable. WebIs bony exostosis benign? Bone is thought to become hyperplastic, consisting of mature cortical and trabecular bone with a smooth outer surface. Create an account to follow your favorite communities and start taking part in conversations. Normal-Appearing Dental Implant with Pain, Peri-Implantitis, and Bone Loss, External Resorption of a Tooth with Pink Appearance, Closure / Repair of Oroantral Fistula (OAF) Caused by Bone Loss Around Dental Implants, Non-Invasive Extraction, Site Bone Graft, and Sinus Lift for Placement of Dental Implant, Jaw Bone Torus or Exostosis (Bony Protrusions): Diagnosis and Treatment. Before about the teeth, Ive never heard of that. The condition is not only benign, but also uncommon and very rarely She was referred to the department for surgical removal of maxillary exostosis in 1999 and related to the surgery a scar adhered to deep planes at the upper right of the vestibule which determined important pain symptoms extending till the right shoulder both during chewing and at rest, interfering with feeding and speaking. B. W. Neville, D. D. Damm, C. M. Allen, and J. E. Bouquot, Eds., Oral and Maxillofacial Pathology, W.B. Additionally, the mucosa covering them is very thin and prone to scratches and injuries from sharp food, sometimes resulting in ulcer formation from the trauma. You seem fixated with the esthetic side of the thing; I'll tell you my experience, do what you want with it. But make no bones about it, we'll give you all the info you need on the types, causes, and potential issues with exostoses to ensure your oral health keeps you smiling. Laboratory findings have demonstrated the presence of mesenchymal multipotent stem cells in the adipocyte cell fraction of fat graft [14]. 1. WebWhen symptoms do happen, they can include: Pain near the joint Stiffness Limited movement Bumps, especially in the hands or feet Swelling Weakness Numbness One leg Would you like email updates of new search results? Korean J Pain. However, they may increase patient concern about poor aesthetics, inability to perform oral hygiene procedures due to difficulty in cleaning around the area with a toothbrush, and compromised periodontal health by causing food lodgement, which could lead to patients reporting increased bleeding when tooth brushing. or am i just shit out of luck and there's nothing i can do? A single ossification center for each half of the mandible arises in the region of the bifurcation of the inferior alveolar nerve into its mental and incisive branches [ 1 ]. At the follow-up examination (3 months postsurgery on the left side and 1 month on the right), the presence of stable periodontal tissue-positioned where it was located during the immediately postoperative period-indicated a satisfactory clinical result.

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