Gingival Recession

GINGIVAL RECESSION

By: Sana Mateen Munshi

ROAD

MAP

DEFINITION

CLASSIFICATION

FACTORS

PROCESS OF RECESSION

PROGRESSION

SYMPTOMS

TREAMENT

PREVENTION

MARGINAL TISSUE RECESSION

Exposition of the radicular surface of the tooth due to destruction of the marginal gingiva and of the juntional epithelium that will be re-established at a more apical position.

BASIC

REVIEW

•MARGINAL GINGIVA + ATTACHED GINGIVA= KERATINIZED GINGIVA•ALVEOLAR MUCOSA•MARGINAL /ATTACHED = FREE GINGIVAL GROOVE•ATTACHED/ ALVEOLAR MUCOSA= MUCOGINGIVAL JUNCTION

MILLAR’S CLASSIFICATION OF GINGIVAL RECESSION:

CLASS I

CLASS II

CLASS II

`

CLASS III

CLASS

IV

SALLIVAN & ATKINS: (1968)

Shallow narrow Deep narrow Shallow wide Deep wide

ETIOLOGYDETERMINANT

FACTORS•Bacterial Plaque

O`Leary et al found direct correlation between the increase of plaque index and the increase of marginal tissue recession

•Trauma from toothbrushing Improper technique Wrong toothbrush

•Iatrogenic Factors Amalgam or prosthetic overhang Clamps Orthodontic appliances

•Habits Fingernails or any foreign object

AMALGAM OVERHANGS

PARTIAL DENTURE CLASP

LIP & TONGUE PIERCING

INADEQUATE ATTACHED GINGIVA

CO FACTORS

• Tooth Malposition Buccally displaced teeth or rotated tooth due to altered tooth-bone relationship

• Unfavorable Anatomy High frenum insertion Shallow buccal fold that produce tension on the marginal gingiva

• Orthodontic Movements

STILLMAN’S CLEFT

PATHOGENESIS

• Pink• Tight to teeth• Scalloped appearance around each tooth

• Swollen• Bleeding• Bright red• Tender to touch

• Gums pull away from teeth• Loose teeth• Pus between teeth and gums

• Roots visible• Temperature sensitivity• Inflamed gums with pus• Tooth loss

PROGRESSION OF RECEDING GUMS:

SYMPTOMS:•Tooth sensitivity

• Toothy smiles

• Notched tooth

• Color change

• Space between teeth becomes wider

If the gum recession is caused by GINGIVITIS, the following symptoms may also be present• Puffy, red, or swollen (inflamed) gums• Gum bleeding while brushing or flossing• Bad breath (halitosis)

TREATMENT Cause-specific treatment in non-progressive gingival recession

Surgical root coverage in progressive gingival recession.

OBJECTIVES:

Problems associated with attached gingiva

Problems associated with shallow vestibule

Problems associated with aberrant frenum

“AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE.”

• Non traumatic plaque control

• Treating gingivitis & peridontitis in early stages

• NO to ORTHODONTICS

• Treat occlusal trauma

• Caution in restorative procedures

• Contours help plaque control

• Design prosthetic appliances