This pilot randomized study compared the clinical effectiveness and patient-reported outcomes of the novel Overlapping Rotated Double (NORD) flap with the Subepithelial Connective Tissue Graft (SCTG) for the management of single isolated RT1 gingival recession defects. Thirty-two systemically healthy adults were randomly assigned to either the NORD or SCTG group. Primary outcomes included reduction in recession depth, percentage of root coverage, and patient-reported measures, while secondary outcomes included gingival thickness, width of attached gingiva, probing depth, and clinical attachment level. The NORD technique utilized a rotated double-flap design using adjacent tissues, whereas the SCTG group was treated with a pouch-and-tunnel approach with connective tissue graft placement. Clinical parameters were recorded at 14-days, 1-month, and 6-months postoperatively. Data were analyzed using analysis of covariance (ANCOVA) with adjustment for baseline values, age, and gingival phenotype. Both procedures resulted in significant clinical improvement. Mean recession depth reduction was 1.66±0.18mm for NORD and 1.48±0.18mm for SCTG (p=0.516), with root coverage of 76.6% and 72.05%, respectively. Secondary clinical outcomes were comparable between groups; however, NORD demonstrated advantages in patient-reported outcomes, including lower postoperative pain, absence of donor-site morbidity, and shorter surgical duration, suggesting it may be a conservative and time-efficient alternative to SCTG.

Synovial cysts of the temporomandibular joint are rare, typically manifesting with local symptoms such as preauricular pain and swelling; magnetic resonance imaging (MRI) is essential for diagnosis. A 45-year-old woman presented with left preauricular pain, limited mouth opening (maximum interincisal distance of approximately 24 mm), and chronic diffuse cervicobrachialgia radiating from the neck to the fingertips. MRI revealed a 6.2-mm cystic lesion at the posteromedial aspect of the left TMJ, associated with disc displacement. Surgical excision via a preauricular approach resulted in complete removal of the cyst, which was confirmed by postoperative computed tomography (CT). Cervicobrachialgia resolved within one week postoperatively. The patient also experienced transient facial paresthesia, which completely subsided within one month. These findings, together with the known overlap between TMJ and cervical innervation, suggest that TMJ synovial cyst excision may alleviate both local and referred distant pain. For general dentists, persistent preauricular pain associated with limited mandibular opening and atypical cervicobrachial symptoms should raise suspicion of intra-articular TMJ pathology when routine dental and musculoskeletal evaluations are inconclusive. Early recognition and referral for MRI assessment may facilitate definitive diagnosis and appropriate management.

Autoimmune disorders exhibit several clinical symptoms, pathophysiological processes, and genetic components, which result in an autoimmune tautology, suggesting that they share similar etiological pathways. Systemic Sclerosis (SSc), also known as Scleroderma, is a potentially fatal systemic autoimmune connective tissue disease with a multifactorial pathogenesis and unknown etiology. The progression of the condition is characterized by substantial bone erosion at the muscle attachment sites. The co-existence of systemic sclerosis and rheumatoid arthritis in the same patient was debatable. Although some research has linked rheumatoid factor to erosive arthritis, indicating a possible overlap between the two conditions, other investigations have not supported these findings. Orofacial tissue involvement is a typical progressive systemic sclerosis (PSS) feature characterized by reduced mouth opening (microstomia), predominantly influenced by cutaneous involvement, and seldom by joint involvement. This report describes the orofacial symptoms of a 56-year-old female patient who had systemic sclerosis and rheumatoid arthritis that progressively coexisted.