Beyond the screw: Exploring the recurrence of oral lesions

The integration of skeletal anchorage systems has revolutionized orthodontics, especially with the advent of mini-screws known for their ease of use and minimal invasiveness.The mandibular buccal shelf area, with its ample high-quality bone and low failure rates, has become a preferred extra-alveolar anchorage site.However, complications involving adjacent soft tissues are common with orthodontic bone screw placement.This case report describes the recurrence of reactive oral lesions following placement of orthodontic bone screws in the buccal shelf area.During the course of orthodontic therapy, the patient developed exophytic growths twice, at the same site, on the lower right back buccal mucosa.Diode laser was used in both instances for excision of the lesion and the specimen was sent for histo-pathological analysis.The first lesion was diagnosed as inflammatory fibrous hyperplasia, while the recurrent lesion was identified as pyogenic granuloma.At 12-months follow-up, no new lesions were detected.This report highlights the influence of lesion development time on its clinical and histological presentation.It is postulated that leaving the bone screw in place after initial biopsy could have contributed to its recurrence.Complete excision is the preferred treatment.Treatment options, including laser therapy, are available for such lesions.