Guided bone and tissue regeneration remains an integral treatment modality to regenerate bone surrounding teeth and dental implants. Barrier membranes have been developed and produced commercially to allow space for bone regeneration and prevent the migration of unwanted cells. Ideal membrane properties, including biocompatibility, sufficient structural integrity and suitable shelf life with easy clinical application, are important to ensure good clinical regenerative outcomes. Membranes have various types, and their clinical application depends on the origin, material, structure and properties. This narrative review aims to describe the currently available barrier membranes in terms of history, main features, types, indication and clinical application and classify them into various groups. Various membranes, including those which are resorbable and non-resorbable, synthetic, added with growth factors and composed of modern materials, such as high-grade polymer (Polyetheretherketone), are explored in this review.

This is a clinical case describing a hypertensive female patient with a drug-influenced gingival enlargement (DIGE) on the labial and lingual gingivae of the lower anterior dentition. DIGE is attributed to the prolonged use of medications in a susceptible individual. She had undergone non-surgical periodontal therapy prior to surgical intervention for the removal of gingival enlargement (GE) using diode laser therapy. A diode laser is a type of laser widely used in dentistry. This laser therapy is a less invasive technique for the removal of GE. After 6 months of follow-up, no recurrence of GE was observed, and regular supportive periodontal therapy was adopted to sustain the gingival health. The utilization of the diode laser showed excellent predictability and clinical outcomes.

Thin gingival phenotype and thin labial plate bone morphotype predispose lower anterior teeth to gingival recession. Free gingival grafthasbecome one of the periodontal plastic surgeries of choice in dealing with aesthetic demand, impaired hygiene care,and dentin hypersensitivity secondary to the gingival recession. The prognosis of free gingival graft as a single augmentation procedure for root coverage is usuallygood and predictable with proper post-surgery care and maintenance. In this casereport, a 28-year-old female patient having gingival recession that was associated with interproximal attachment loss less than to the buccal site,limited keratinised tissues,and thin gingival phenotype in relation to teeth 31 and 41 that was treated using autogenous graft which harvested from hard palate mucosa with satisfactory postoperative results.

This clinical case describes using a milled crown on a cracked tooth as the abutment for a removable partial denture. A 63-year-old male patient diagnosed with lipoma undergoing chemotherapy and radiotherapy presented with symptomatic crack tooth syndrome on tooth 36 and partial edentulism. Conservative treatment using a molar band to extracoronally splint the tooth was conducted to determine the prognosis of the crack line. A lower partial cobalt-chromium denture was constructed by incorporating the milled crown of tooth 36 as the abutment. After six months of follow-up, there were no crack tooth symptoms, and regular review was adopted to monitor the tooth. The construction of a milled crown of a cracked tooth presented good and promising clinical outcomes in preserving tooth vitality and preventing crack propagation in partially dentate dentition for the long term.

Patient-centred care dentistry offers positive treatment outcome by unique combination of dental practitioners and their patients to improve quality of care and overall health outcomes. As Muslim dental practitioners, they must adhere with the Islamic principles and values in treating their patients with the Maqasid Shari’ah that blended in patient centred care approach. The concept of Maqasid Shari’ah is the purpose and objective of Shari’ah that formulated in the protection of religion, soul, mind, heredity and property. Apart from that, Qawaid Fiqhiyah is the methods that used in solving dental fiqh issues nowadays and that legal maxims is endorsed by the Muslim scholars or authorities. Finally, the dental treatment goal is to increase patients’ quality of life as a servant of Allah and khalifah in the Earth.

Gingival overgrowth (GO) or enlargement is an unwanted effect occurring on the gingiva that commonly associated with medications. Hypertension is a global burden systemic conditions and showed high prevalent and more patients are taking antihypertensive drugs. Objective: This study aimed to assess the prevalence of drug-induced gingival overgrowth (DIGO) and its associated risk factors among hypertensive patients attending Hospital Universiti Sains Malaysia, Kelantan, Malaysia. Methods: A total of 42 patients with the mean age of 57.1 (SD=9.3) years had participated in this cross-sectional study. They were recruited if they had consumed anti-hypertensive agents for at least 6 months. Demographic data and oral hygiene status were recorded and the presence of DIGO was assessed based on clinical index for gingival overgrowth. Data were analyzed using SPSS version 24.0 with p < 0.05 is considered statistically significant. Results: Majority of patients were taking calcium channel blockers (CCB) (81.0%) with amlodipine reported as the most common antihypertensive prescribed (47.6%). About 52% presented with DIGO and among them 55.9% were in those on CCB by which 9.5% presented with clinically significant enlargement. Except for gingivitis, oral hygiene status and demographic data were not significant risk factors for DIGO (p > 0.05). Conclusion: We found that DIGO is prevalent among hypertensive patients on CCB and its occurrence is coexists with gingivitis. Therefore, periodontal assessment is recommended among these patients for early detection and management of drug-induced gingival overgrowth.

Drug-influenced gingival enlargement (DIGE) or overgrowth manifests as abnormal enlargement of the gingiva due to an adverse effect of certain drug reactions in patients treated with anticonvulsants, immunosuppressants, or calcium channel blockers (CCBs). As the gingival enlargement became significant, it may interfere with the normal oral hygiene measures, aesthetics, as well as masticatory functions of the patients. The exact mechanism of how this undesirable condition develops is yet unknown, and complicated, with non-inflammatory and inflammatory pathways involved. This review illuminates these putative pathways of DIGE and highlights various treatment approaches based on existing research and current observations.

Associationsbetween periodontal disease (PD) and other diseases, including rheumatoid arthritis (RA), respiratory disease, and chronic kidney disease, have been reported. Patients with moderate to severe periodontitis have a high risk of suffering from RA and vice versa. This bidirectional relationship could be due to genetic (HLA-DR), dysregulation of the inflammatory response, and the role of Porphyromonas gingivalis(P. gingivalis), which stimulates anti-cyclic citrullinated peptide antibodiesvia citrullination. This review aims to identify associated factors that contribute to RA and PD relationship and to explore the effects of disease-modifying anti-rheumatic drugs (DMARDs) on PD. A literature search was performed using PubMed and Google Scholar to identify related articles published from the year 1990 to 2020 within the research interest using keyword combinations. Thirty-one articles thatfit the research interest and address the research questions for both objectives were selected. As a result, the associated factors for RA and PD relationship, including genetic predisposition, immunoregulatory imbalance, and the role of P. gingivalisin the citrullination process as a risk factor of RA. Significant improvement was found in periodontal parameters in RA patients treated with biologic and synthetic DMARDs. This review reported common factors contributing to the RA and PD relationship and the benefits of DMARDs on periodontitis.

Drug-influenced gingival enlargement (DIGE) among hypertensive patients is commonly associated with antihypertensive drugs such as calcium channel blockers (CCBs). Immune response alteration is one of the proposed mechanisms for DIGE. Immunoglobulin A (IgA) in saliva which involves in defense mechanism was shown to be affected in patients with DIGE. Objective: This study aimed to determine the association of salivary IgA level with DIGE. Methods: This cross-sectional study comprised 47 hypertensive patients who had consumed antihypertensive drugs for at least 3 months. Twenty-one (44.7%) males and 26 (55.3%) females had participated in this study. Data was analyzed using SPSS version 26.0. The p-value of less than 0.05 at a 95% confidence interval is considered statistically significant. Results: Eighty-three percent and 17.0% of hypertensive patients were on CCBs and non- CCBs respectively. Amlodipine was found to be the most common (55.3%) antihypertensive drug consumed. Twenty- one (44.7%) patients presented with DIGE. The salivary IgA level was significantly decreased (p=0.03) among hypertensive patients with DIGE [Median 4.9 ng/mL (IQR 5.268)] compared to those without DIGE [median 15.03 ng/mL (IQR 32.246)]. Conclusion: This data indicates the level of salivary IgA was significantly affected in patients with DIGE which may compromise the defense mechanism of saliva.

This is a clinical case describing a hypertensive female patient with a drug-influenced gingival enlargement (DIGE) on the labial and lingual gingivae of the lower anterior dentition. DIGE is attributed to the prolonged use of medications in a susceptible individual. She had undergone non-surgical periodontal therapy prior to surgical intervention for the removal of gingival enlargement (GE) using diode laser therapy. A diode laser is a type of laser widely used in dentistry. This laser therapy is a less invasive technique for the removal of GE. After 6 months of follow-up, no recurrence of GE was observed, and regular supportive periodontal therapy was adopted to sustain the gingival health. The utilization of the diode laser showed excellent predictability and clinical outcomes.