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Gingival recession

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Gingival recession Gingival recession Presentation Transcript

    • GINGIVAL RECESSION
    • CONTENTS :
    • 1. Definition
    • 2. Classification
    • 3. Etiology
    • 4. Clinical examination
    • 5. Clinical significance
    • 6. Treatment
  • DEFINITION
    • It is the exposure of root surface by an apical shift in the position of gingiva.
  • 3
    • The recession is determined by
    • the actual position of the gingiva
    • not by its apparent position
  • 5.
    • Recession can be studied as,
    • VISIBLE
    • HIDDEN
    • Also it may be
    • Localised Generalised
  • CLASSIFICATION OF RECESSION DEFECTS
    • P.D.MILLER(1985)
    • Class I : Marginal tissue recession not extending
    • to the mucogingival junction. No loss of
    • interdental bone or soft tissue.
    • Class II : Marginal tissue recession extends to or
    • beyond the mucogingival junction. No
    • loss of interdental bone or soft tissue.
    • Class III : Marginal tissue recession extends to
    • or beyond the mucogingival junction.
    • Loss of interdental bone or soft tissue
    • is apical to the CEJ, but coronal to the
    • apical extent of marginal tissue
    • recession
    • Class IV : Marginal tissue recession extends
    • beyond the mucogingival junction.
    • Loss of interdental bone extends to a
    • level apical to the extent of the
    • marginal tissue recession.
  •  
    • Atkin & Sullivan classification
    • I. Shallow-Narrow
    • II. Shallow-Wide
    • III. Deep-Narrow
    • IV. Deep-Wide
    • Etiology:
    • 1. Age
    • 2. Faulty tooth brushing technique
    • 3. Tooth malposition
    • 4. Gingival inflammation
    • 5. Abnormal frenal attachment
    • 6. Trauma from occlusion
    • 7. Masochistic habits
    • 1. Age
    • It inraeses with age.
    • 8% in children
    • 50%, above age of 50 yrs
    • Reason being ,
    • (a) Cummulative effect of minor
    • pathological involvement
    • (b) Repeated, minor direct trauma
    • 2. Faulty tooth brushing technique
    • Brush with hard bristles
    • Excessive or Aggressive brushing in horizontal direction.
    • When used with highly abrasive dentrifice
    • A Wedge shaped defect
    • Surface – clear, smooth , polished.
  •  
    • 3. Tooth malposition
    • Recession is affected by :
    • a. Position of teeth in the arch.
    • b. The root bone angle.
    • c. The mesiodistal curvature of the tooth
    • surface
    • d. Rotated, tilted or facially displaced teeth
  •  
    • If the inclination of the root is not proper, then the bone in the cervical area is thinned or shortened and recession results from repeated trauma of the thin marginal gingiva.
    • Pressure from mastication or moderate tooth brushing damages the unsupported gingiva and produces recession.
    • Malpositioned teeth
    • 4. Gingival inflammation
    • 5. Abnormal frenal attachment
    • 6. Masochistic Habits
    • Clinical examination
    • Measurement of amount of gingival recession is made by Periodontal probe from CEJ to the gingival crest
    • Clinical significance:
    • 1. Exposed root surfaces are susceptible to
    • caries.
    • 2. Abrasion or erosion of the cementum
    • Underlying dentinal suface
    • Sensitivity
    • 3. Hyperemia of pulp may also result from
    • excessive exposure of root surfaces.
    • 4. Interproximal recession creates oral
    • hygiene problems & resulting plaque
    • accumulation
    • Treatment
    • It can be treated
    • Non-surgically
    • Surgically
    • NON – SURGICAL METHOD
    • 1. Correction of tooth brushing technique
    • 2. Removal of masochistic habits
    • 3. Correction of malocclusion
    • 4. Treating the dentinal sensitivity
    • Surgically treated by two procedures :
    • 1. Pedicle soft tissue graft procedures :
    • Flaps used : Rotational flap
    • Advanced flap
    • 2. Free soft tissue graft procedures :
    • Epithelialised graft
    • Sub epithelial connective tissue graft
    • ROTATIONAL FLAP PROCEDURES
    • Lateral sliding flap
    • Double papilla flap
    • ADVANCED FLAP
    • Coronally Advanced flap
    • Semilunar Coronally Advanced flap
    • Lateral sliding flap
    • Clinical view :
    • Double papilla flap procedure
    • ADVANCED FLAP PROCEDURES
    • Coronally advanced flap
  •  
    • Semilunar coronally repositioned flap
    • Guided tissue regeneration
  •  
  •  
    • FREE SOFT TISSUE GRAFT PROCEDURES
    • Epithelialised graft
    • Sub epithelial connective tissue graft
    • Epithelialized free soft tissue graft procedure
  • Free connective tissue graft combined with a coronally advanced flap procedure
    • REFRENCES :
    • 1. Carranza : Textbook of Periodontics
    • 2. Jan Lindhe : Clinical periodontology and
    • Implant Dentistry