Wednesday, December 9, 2009
Tolerating a Fenestration
Nancy came for a cleaning, but it had been quite a long time since her last cleaning due to some medical issues she was dealing with. When I examined her, I noticed what is apparent in the photo above (mirrored image). This "fenestration", or "window" through her gums was caused by slow, steady pressure on her gums from an ill fitting removable partial denture.
The term fenestration comes from the Italian word for window: finestra. Through the window, you can see the roots of her lower front teeth. She also has clefting on a couple of her teeth. This is similar to a fenestration, but communicates all the way up to the crown of the tooth.
An unusual cause for this fenestration was the fact that Nancy's partial put pressure in that area, and she just tolerated it. I guess you can tolerate alot when it comes at you slowly. As her lower partial settled down in back due to slow bone loss in her lower jaw, her partial rotated down and forward behind her front teeth. This caused the pressure and loss of gum tissue in that area.
Our treatment for this is to first take the pressure off of the gums from the partial. Today, I placed a medicated liner under her partial which lifted the back of the partial up, and rotated the metal from the partial back and away from this area. She will soon be healing, and returning for long-term relining of her partial. She may need periodontal care for repair of the fenestration, and certainly she will need these teeth cleaned up!