GINGIVAL RECESSION

• GINGIVAL RECESSION : • GINGIVAL RECESSION DEFINITION: When the edge of the gum

(gingival margin) moves apically along the root surface of a tooth (away from the crown), resulting in exposure of the root.

• Stillman’s cleft : • Stillman’s cleft Small fissures extending apically from the midline of

the gingival margin in teeth subjected to trauma. Although these clefts may be found in traumatism, they are not necessarily diagnostic of occlusal trauma

• Classification of Gingival RecessionMILLER PD et al 1985 : • Classification of Gingival RecessionMILLER PD et al 1985 Class I

Marginal tissue recession which does not extend to the mucogingival junction No periodontal bone loss in the interdental area 100% root coverage

• Class II Marginal tissue recession which extends to or beyond the mucogingival junction No periodontal loss in the interdental area 100% root coverage

• Class III Marginal tissue recession which extends to or beyond the mucogingival junction Bone or soft tissue loss in the interdental area or malpositioning of the teeth, preventing 100% root coverage Partial root coverage

Class IV Marginal tissue recession which extends to or beyond the mucogingival junction Severe bone or soft tissue loss in the interdental area and/or malpositioning of teeth No root coverage

• Process of Recession Wounding may cause a split in the gingiva with resultant root exposure Existing gingiva may move apically with resultant root exposure

•INVESTIGATION :

• INVESTIGATION The tests that are usually carried out are: Radiographs (X-rays) Testing nerve of tooth (vitality testing) Probing the gingiva (gum) to look for signs of deeper periodontal disease Checking the occlusion (way that the teeth bite together) Measuring the amount of recession with a graduated probe

•HOW TO GROW BACK GINGIVAL RECESSION :

• HOW TO GROW BACK GINGIVAL RECESSION Gum recession is the condition when the gum tissue pulls away from the teeth, exposing the roots of the teeth. It is a common condition for adults above the age of 40. the gums are the protective tissue that surrounds and support the tooth. Gum recession results in retraction of the gum line, exposing more and more of the teeth to the mouth’s environment. This may result in accelerated tooth decay and loosening of the teeth. Gum recession treatments are varied and depend on the cause of the condition and its severity. Surgical and non surgical receding gum treatments are available. NON SURGICAL TREATMENT SURGICAL TREATMENT

• NON SURGICAL TREATMENT : • If the gum recession is not severe and can be halted and grown back

by simple alteration of the mouth’s environment, then non-surgical options are proposed. This is generally the case for bacterial infections of the gum, particularly those in an early stage. In these cases, a professional deep cleaning of the periodontal pockets is recommended. This involves removal of plaque and tarter above and below the gum line in order to reduce the sources of bacterial infection. NON SURGICAL TREATMENT

• SURGICAL METHODS OF GROWING BACK GUM : • Surgical gum recession treatment methods are employed in more

advanced cases, where the receded gum line is unlikely to grow back with simple means. The following receding gum treatments are available. SOFT TISSUE GRAFT. BONE GRAFT. 1) SOFT TISSUE GRAFT. This involves taking gum tissue from other parts of the mouth (e.g. the palate or healthier parts of the gum), placing it over the exposed places and suturing them in place. This procedure quite easy on the patient. It requires only mild painkilling treatment and lasts for a lifetime with proper care. SURGICAL METHODS OF GROWING BACK GUM

• BONE GRAFTS : • Exposure of the root can lead to atrophy of the jawbone as a result of

bacterial infection. Bone grafts can grow back the bone, making it easier to hold teeth and gum. Bone tissue can be taken from the jaw, hip, or tibia and placed in the jawbone. Special membranes are inserted to protected to protect it and assist in bone regeneration. BONE GRAFTS

• Complications of Disorder : • Recession can lead to: Aesthetic (appearance) concerns Tooth sensitivity to foods /

drinks (especially cold) Loss of tissue from the root surface (erosion / abrasion) Caries (decay) of the root, which has no enamel cover to protect it Greater risk of periodontal disease, as there is a greater surface area for the plaque to adhere to, which also makes it harder for the patient to clean. And in the case of severe recession: Mobility (looseness) of teeth Loss of vitality (death of nerve) of the tooth Complications of Disorder

•SURGICAL TREATMENTGingival Grafts :

• SURGICAL TREATMENTGingival Grafts •

Outcome/prognosis : • Outcome/prognosis Early detection Maintain tissue free of inflammation Removal of any

causative thing.

• SEVERITY AND SCORING OF GINGIVAL RECESSION : • SEVERITY AND SCORING OF GINGIVAL RECESSION Scoring of the

gingival recessions at the buccal aspect according to the classification of MILLER (1985) revealed that Class I recessions were the most prevalent, yet its frequency was gradually decreased as age increased. Class IV recessions, regarded as the most severe according to the classification of Miller, displayed an increasing occurrence with the increase in age.