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Illustrates basic concepts of Gingival Recession.
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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