Introduction gingival recession is a widespread clinical manifestation affecting single or multiple root surfaces at all teeth types. Gingival recession is associated with oral exposure of the root surface due to a displacement of the gingival margin apical to the cementoenamel junction. Discussion this case report evaluated the treatment of localized gingival recession by using palatal connective tissue graft for the treatment of class ii miller recession. Free gingiva the zone closest to the tooth crown is the free gingiva, which is the tissue that is not firmly attached to the tooth or alveolar bone. Gingival recession management a clinical manual adrian. The recession of the gingiva is increasingly becoming a more prominent condition in the oral health of many patients and should be treated at its earliest detection. Clinical case report autogenous connective tissue graft. Gingival recession defects not extending to mucogingival junction. Understand why gingival recession is a concern both functionally and aesthetically for the soft and hard tissue. Gingival recession is defined as an apical displacement of soft tissues to the cementoenamel junction cej. In the youngest age cohort 30 to 39 years, the prevalence of recession was 37. The grafted area healed well and full coverage was achieved at 12month followup visit. Rapid gum recession and gum grafting oral and dental.
The use of free gingival grafts to treat recession defects in patients with esthetic requests is not recommended because of the poor esthetic. Gingival recession can be localized or generalized and be associated with one or more surfaces. Studies have shown that 50% of people between 1864 years of age have one or more sites with recession and 23. Sites wer e randomly assigned to either caf treatment contr ol, n 10 or gtrf treatment test, n 10 and examined at baseline and at 6 months postoperatively. Surgical treatments also can help, such as grafts that attach gum tissue from one part of your mouth to the exposed area. Treatment of recession and mucogingival defects using. Preoperative view showing miller class ii recession associated with tooth 41. Whatever the reason, the downsides of recession are the same. Gum recession treatment it can be painful and ugly to have receding gums. Abstract gingival recession is the term that designates the oral exposure of the root surface due to a displacement of the gingival margin apical to the cementenamel junction. The aim of this study was to investigate the clinical outcome of initial therapy with subgingival low. Gingival recession checklist is especially helpful to the clinician when developing treatment plans. The root surface doesnt have a covering of enamel to protect it so any change in temperature can irritate the nerve quite easily. Treatment of recession and mucogingival defects using connective tissue grafts on teeth and implants 39 ply to the graft increases its success rate 10, 55, 56.
Gum recession is quite prevalent in the general population with some estimates showing up to 80% of individuals may have some form of this condition. Diagnosis and treatment of gingival recession decisions. The digits describe the horizontal and vertical components of a recession site in that order. Your treatment options depend on the type and severity of your gum recession. Pdf gingival recession associated with orthodontic. Reduction of gingival recession and of hypersensitivity were maintained at least until the final evaluation at months. Multiple gingival recession, connective tissue graft, leukocyte and plateletrich fibrin. Treatment of gingival recession using free gingival graft. Gum recession is a major concern for many of our patients due to the poor esthetics and the possibility of sensitivity and decay. Assessment of creeping attachment after free gingival graft in. Patient preparation reevaluation after initial treatment srp may eliminate some pocket depths can firm the tissue o inflamed tissues have capillary loops, are less firm o sutures tear more easily through inflamed tissues gives time for patient educationcomfort o poor homecare is a contraindication for surgery. A mucogingival technique for the treatment of multiple. Free gingival graft as a single step procedure for treatment of.
Periodontal plastic surgery is now an important tool in the armamentarium of the clinician treating gingival recessions, and practitioners at all levels will find. Materials and methods in this study, comparison tests using the alcoholfree 0. Where the gum has shrunk back to reveal the root surface, this will often be very sensitive to temperature. Gingival recession is a common condition in the adult population and is related to several undesirable conditions such as unaesthetic appearance, root caries, and hypersensitivity. Twenty patients, who had at least two teeth with pocket depths 5 mm in each quadrant, took part in this prospective randomized. If you have gum recession, your dentist can help you understand the causes and recommend a treatment. Recognition and treatment of equine periodontal disease scott k. Treating gingival recession ronan allen presents a practical guide to assessing and diagnosing mucogingival deformities, and discusses common treatment modalities involved in root coverage over the last few years dentistry has evolved in such a way that clinicians are not only required to treat disease and improve function but also to cope with. Whether it could substitute ultrasonic scaling to remove dental plaque biofilm during periodontal maintenance remains unclear. It is the most common and undesirable condition of the gingiva.
The suggested treatment plan comprised of root coverage combined with xenograft bone particles. Gingival recession associated with orthodontic treatment and root coverage. Conventional macrosurgical approach for site a and microsurgery for site b was applied in performing the free rotated papilla autograft combined with coronally. Gingival recession, also known as receding gums, is the exposure in the roots of the teeth caused by a loss of gum tissue andor retraction of the gingival margin from the crown of the teeth. Introduction gingival recession gr is defined as the exposure of the root surface due to the displacement of the gingival margin apical to the cementoenamel junction cej. It surrounds each tooth to form a collar of tissue with a potential space or gingival sulcus crevice hidden between itself and the tooth. The recession of gingiva, either localized or generalized, may be associated with one or more surfaces, resulting in attachment loss and root exposure, which can lead to clinical problems such as root surface hypersensitivity, root caries, cervical root abrasions, difficult plaque control, and diminished cosmetic. The purposes of this study were to evaluate the effect of supragingival glycine air polishing sgap on the subgingival periodontal pathogens during maintenance therapy and. New treatment for gum recession breaks new ground receding gums is a clear sign of gum disease, which many people might ignore. Gum recessionmucogingival defects and soft tissue grafting. The multifactorial etiology, decision modality, and current trends followed in the treatment of gingival recession are discussed in this presentation. Its use during treatmentprocedure planning can help guide the clinician toward options that can potentially decrease the risk of damage to tissues e. Gingival recession regions, in the absence of a mucogingival problem, in which there is an esthetic or hypersensitivity consideration, can be also managed with free gingival graft fgg.
Background glycine air polishing has been proved to be safe, comfortable and timesaving. Gingival recession with exposed root colgate professional. An understanding of the etiology, pathogenesis, and treatment options of periodontitis can help veterinarians prevent one of the primary causes of equine tooth loss. Gum recession can be difficult to selfdiagnose in its earlier stages because the changes often occur asymptomatically and gradually. But untreated gingivitis can progress to periodontitis, a serious infection that destroys the soft tissue and bone that support your teeth, and eventually may cause tooth loss. One study showed recession defects of 35 mm only managed to attain 80. Index of recession smith described by two digits separated by a dash prefixed letter f or l denotes facial or lingual denotes involvement of mucogingival junction 58. Gum recession is most common in adults over the age of 40, but the process can begin in the teenage years. Gum recession, however, can be treated by a qualified periodontist. When the kth is greater than 1 mm but less than or equal to 2 mm, it is critical to measure gt. There is a direct correlation between flap tension and reduced root coverage, and between tissue thickness and the percentage of.
Treatment of localized gingival recession using the free rotated. When teeth are healthy, gum tissue fits around each tooth like a cuff. Gum recession can cause problems for your dental health. Treatment of gingival recession with subepithelial. This condition complicates the diagnosis and treatment of gingival recession. Geistlich mucograft for the treatment of multiple adjacent recession.
While each individuals presentation is unique there are some common predisposing factors that increase the likelihood of gum recession. The rationale for this treatment includes 1 a smaller surgical site and a reduction in treatment time through a combined approach and 2 faster healing in the donor area by primary closure of the wound area. Earlystage periodontal disease gingivitis is seldom painful and causes relatively minor signs, such as red, swollen and bleeding gums. The gingival veneer is a viable treatment option for restoring anterior esthetics in clinical situations where there are esthetic concerns caused by significant gingival recession. Both treatments resulted in a significant reduction in recession and gain in clinical attachment level. The two commonest causes of receding gums are plaqueinduced gum inflammation and toothbrush trauma, revealing dehiscence in jaw bone. Gingival recession introduction gingival recession is characterized by the displacement of the gingival margin apically from the cementoenamel junction, or cej, or from the former location of the cej in which restorations have distorted the location or appearance of the cej. While anatomical features may contribute, these and trauma from occlusion, high frenal attachments. This book is designed to function a clear and concise clinical guide that covers all components of the modern control of gingival recession, with a particular cognizance on surgical strategies with the adjunctive use of autogenous tissues or smooth tissue substitutes for recession coverage.
Neglecting brand promotion during an economic downturn will result in weakening the brand and making it less profitable postrecession. My treatment goals included completing root coverage of the recession defects. It is a common oral health problem in adults, but teenagers are also susceptible to this condition. If you continue browsing the site, you agree to the use of cookies on this website. Become familiar with the causes of gingival recession and two alternate treatment options available to correct it. Provides clinicians with an evidencebased and stepbystep treatment. Gum recession is a condition when the roots of the teeth are exposed due to the loss of gum tissue. Patient preparation reevaluation after initial treatment. The effect of supragingival glycine air polishing on. Patients were instructed to avoid mechanical cleaning with either a toothbrush or toothpick for 4 days. Gingival recession is often associated with abrasion in the cervical area with an unidentifiable cementoenamel junction cej.
Treatment of a receding gum line intelligent dental. Table 2 shows the second digit of the ir that gives the vertical. Id also like to add that i got a gum graft using cadaver tissue, i forget the name of it but its basically other peoples gums but cleans and made for patient use, rather. Gingival recession and root caries in the ageing population. Therefore basic periodontal care and correction of faulty tooth brushing techniques are the first lines of treatment. Sarhang sarwat gul1,2, faraedon mostafa zardawi1, aram. The aim of this study was to propose a technique to identify the cej level for planning periodontal and restorative treatment of the recession. A total of 44 miller class iii g ingival recessions that were b ilateral, adjacent and greater than. The desire for an agent, which will produce a biostable union between tissue planes has led to the development of tissue adhesive, fibrin sealant that is. Boneadded periodontal plastic surgery can be considered as a practical procedure for management of deep gingival recession without buccal bone plate. This paper is the second in a three part series looking at the aetiology and management of gingival recession. The horizontal component is expressed as a whole number value from the range 05 depending on what proportion of the cej is exposed on either the facial or lingual aspects of the tooth, between the mesial and distal midpoints. Coverage of gingival recession using tunnel connective.
Regular dental check ups will help to prevent gum recession and assess risk factors. According to the us national survey, 88% of seniors age 65 and over and 50% of adults 18 to 64 present recession in one or more sites. Ajay mahajan modified the millers classification as following. Autologous free gingival grafts and connective tissue grafts have. In a tooth with gum recession, the gum tissue has pulled away from the tooth. Clinical effects after subgingival polishing with a non. New treatment for gum recession breaks new ground new. However, bacterial plaque is of equal importance in the aetiology of gingival recession. Gum recession is a common problem in adults over the age of 40, but it may also occur starting from the age of a teenager, or around the age of 10. Recognition and treatment of equine periodontal disease. Gingival recession management a clinical manual adrian kasaj. Pdf plateletrich fibrin in the treatment of gingival. Gingival recession is a common occurrence and its prevalence increases with age. Download pdf gingival recession management dencyclopedia.
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