Gingival recession and periodontal therapy

2019 ◽  
Vol 31 (1) ◽  
pp. 31-36
Author(s):  
Monya N. Hassan ◽  
Maha A. Aziz

Background: Gingival recession is defined as the apical migration of the gingival margin below the cementoenamel junction (CEJ), resulting in exposure of the root surface and it is one of the main esthetic complaints of patients. The management of gingival recession and its sequelae is based on a thorough assessment of the etiological factors and the degree of tissue involvement.

2020 ◽  
pp. 25-31
Author(s):  
P. Mazur ◽  
I. M. Suprunovych

Gingival recession is a common clinical condition in the dental practice, which is characterized by the root surface exposure due to the apical displacement of the marginal gingival tissues. Since the teeth' root surfaces become open to the environment of the oral cavity, the consequences of gingival recession are a disturbance of aesthetics (mainly when they occur in the frontal area), the development of hypersensitivity root caries, and non-carious cervical lesions. Despite the numerous studies carried out, the exact mechanism of the development of gingival recession is not fully understood, and it is generally accepted that it has a multifactorial etiology. Gingival recession can occur directly due to an infectious and inflammatory process in the periodontal tissues, anatomical features, as a result of the effect of mechanical or iatrogenic factors on soft tissues, or their action in combination with each other. The prevalence of gingival recessions worldwide varies from 22 to 100% and mainly depends on age, the size of the studied population, diagnostic criteria, and statistical data processing methods.  The aim was to determine the influence of age on the prevalence of gingival recession in patients with periodontitis.  Materials and methods. One hundred thirty-three patients with periodontitis aged 29 to 59 years were included in the study and divided into four groups according to their age: 20–29 years, 30–39 years, 40–49 years, 50–59 years. Inclusion criteria were the presence of periodontitis, age over 20 years, and the presence of more than 20 teeth in the oral cavity.  Participants were interviewed about demographic data, smoking status, and oral hygiene skills. All patients underwent a clinical examination using the clinical and instrumental program Florida Probe system. Gingival recession was recorded in the presence of root surface exposure of 1 mm or more. According to the size of the exposed surfaces of the tooth roots, three degrees of severity of gingival recession were assessed: mild gingival recession (less than 3 mm), moderate gingival recession (3 to 4 mm), severe gingival recession (5 mm or more). The severity of gingival recession was estimated in mm as the distance between the cemento-enamel junction and the gingival margin. Subsequently, the gingival recession was classified using the Miller recession classification [7]. Results of the studies and their discussion. The study results showed that a high prevalence of gingival recession was found in patients with periodontitis in the Ukrainian population. Exposure of the surface of the teeth' roots by 1 mm or more was present in around 2233 teeth, which corresponds to 65.86 (61.4-70.3)% of all examined teeth. The average number of teeth with the gingival recession increases with age: in those aged 20-29, the gingival recession was present in 42,86% of the teeth, in patients 30-39 years of age, the gingival recession was present in around 59,59% of the teeth, in patients 40-49 years of age the gingival recession was present in around 70,49% of the teeth, in those, older than 50 years, the gingival recession was present in around 82.72% of the teeth. Incisors and first molars were the most affected teeth by the gingival recession. In patients with periodontitis, the gingival recession of mild degree (up to 3 mm) was determined around 44.01 (40.8-47.2) % of teeth, the gingival recession of moderate degree (from 3 to 4 mm) – around 17.41 (14.3-20.5) % of teeth, the gingival recession of severe degree (5 mm or more) – around 4.42 (2.7-6.2)% of teeth. The severity of recession in patients of different age groups was determined: the gingival recession's severity increases with age. The average severity of gingival recession (the length from the cemento-enamel junction to the gingival margin) was determined in patients of different age groups: in the group of 20 years old, it was 0.28 ± 0.28 (M ± SD) mm, in the group of 30 years old – 0.43 ± 0.37 (M±SD) mm, in the group of 40 years old – 0.78 ± 0.70 (M ± SD) mm, in the group of 50 years old – 1.20 ± 0.70 (M±SD) mm. According to the Millers classification, Class III of the gingival recession was more common in age groups I and II, Class IV of gingival recession, which have an unfavourable prognosis of treatment, were more often manifested in older patients age groups.


2020 ◽  
Vol 12 (2) ◽  
pp. 91-95
Author(s):  
Mohammad Ahmad Javaid ◽  
Aamna Sohail ◽  
Raafay Ahmed

Gingival recession defined as the apical migration of the gingival margin leads to the exposure of root surface. This in turn may lead to compromised esthetics, dentine hypersensitivity and attachment loss. Severe gingival recession is typically managed surgically. However, achieving complete root coverage in cases of severe gingival recession, especially in the mandibular canine region is quite challenging. Different surgical techniques have been described in the literature to manage this condition. Tunnelling technique is one such technique which has shown promising results. Use of connective tissue graft with tunnelling technique has demonstrated favorable results in cases with mild to moderate gingival recession. Here we report a case where connective tissue graft was used in conjunction with tunnelling technique to achieve complete root coverage despite severe gingival recession and unfavorable prognosis.


2017 ◽  
Vol 05 (03) ◽  
pp. 124-126
Author(s):  
Gaurav Arora ◽  
Vikram Blaggana ◽  
Preeti Upadhyay ◽  
Pragya Tripathi

AbstractGingival recession is defined as apical migration of gingival margin in relation to cement enamel junction. The laterally repositioned flap is used to cover denuded root surface that has adequate donor tissue laterally as well as adequate vestibular depth. This article highlights the use of laterally repositioned flap for the management of localized Miller's Class II gingival recession. An excellent esthetic outcome was achieved and patient was satisfied with case resolution.


2019 ◽  
Vol 2 (2) ◽  
pp. 13-17
Author(s):  
José Ricardo Kina ◽  
Eunice Fumico Umeda Kina ◽  
Juliana Kina ◽  
Mônica Kina

Areas of gingival recession cause either an esthetic problem and or root sensitivity. Obtaining predictable root coverage has become an important part of periodontal therapy. A deep, long – standing recession promoted by ANUG was treated using subepithelial connective tissue graft technique combined with decontamination of root surface by using Er:YAG laser. Our clinical findigs suggest that this technique is a predictable procedure to treat gingival recession and promote root decontamination.


Author(s):  
Hardi Rajanbhai Shukla ◽  
Aditi Mathur ◽  
Neema Shetty ◽  
Barkha Makhijani ◽  
Balaji Manohar

Background: Biofilm removal is the central part of the etiotropic and maintenance phase of periodontal therapy. Commercially available injection water jets such as Prophy-Jet allows an efficient and convenient biofilm removal as an adjunct to mechanical periodontal therapy. But, due to the abrasive nature of traditionally used air polishing powders such as sodium bicarbonate, there is a continuous research going on for less abrasive materials. Aims: To compare the effectiveness of air polishing using glycine powder and chlorhexidine acetate powder on tooth surface as compared to ultrasonic scaling and also to evaluate the time taken for stain removal. Materials and Methods: Thirty fully erupted, single rooted teeth extracted due to poor periodontal prognosis were used in this in-vitro study. The sample teeth were divided into 3 equal groups and stained in coffee solution. The test Groups A and B underwent air-polishing with glycine powder and chlorhexidine acetate powder respectively. Group C was control group and underwent ultrasonic scaling. Time taken for stain removal was recorded. The sample teeth were also evaluated under a stereo-microscope and digital micrometer preprocedurally and post-procedurally to measure surface changes. Results: The study showed statistically significant results (p<0.05) when measurements of changes in surface roughness of samples treated with glycine powder air-polishing were compared with ultrasonic scaling and chlorhexidine acetate powder air-polishing were compared with ultrasonic scaling. Surface texture loss as well as time taken for stain removal was minimum with glycine powder and maximum with ultrasonic scaling. Conclusion: Air-polishing with glycine powder was least abrasive on root surface followed by chlorhexidine acetate powder air-polishing. This is because of the lower particle size of glycine which also covers larger area in lesser time.  


e-GIGI ◽  
2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Lilies Rizkika ◽  
Christy N. Mintjelungan ◽  
Kustina Zuliari ◽  
Johanna Khoman

Abstract: Gingival recession is the displacement of marginal gingiva to the apical direction of the cementoenamel junction due to the loss of alveolar bone attachment tissue resulting in exposure of the root surface of the tooth. Wrong technique of tooth brushing is one of the causes of gingival recession. This study was aimed to determine the correlation between tooth brushing techniques and gingival recession among the coastal coast community at the Megamas area of Manado. This was an analytical study with a cross sectional design. Sampleswere obtained by using total sampling method. Tooth brushing techniques were observed by looking at the way the respondents brushed their teeth. We provided check lists in accordance with the techniques they used. Data of gingival recession were obtained by examination of the oral cavity and then we calculated the severity of gingival recession. There were 43 respondents involved in this study. The result of the Kolmogorov-Smirnov obtained a p-value of 0.000. In conclusion, Yjere was a relationship between tooth brushing technique and the severity of gingival recession.Keywords: gingival recession, tooth brushing technique Abstrak: Resesi gingiva adalah perubahan posisi tepi gingiva ke arah apikal dari cemento enamel junction karena hilangnya jaringan perlekatan tulang alveolar sehingga mengakibatkan terbukanya permukaan akar gigi. Kesalahan teknik menyikat gigi merupakan salah satu penyebab resesi gingiva. Penelitian ini bertujuan untuk mengetahui hubungan teknik menyikat gigi dengan keparahan resesi gingiva pada masyarakat pesisir pantai di Kawasan Megamas Kota Manado. Jenis penelitian ialah analitik dengan desain potong lintang. Pengambilan sampel dilakukan dengan metode total sampling. Pengambilan data dilakukan dengan cara melihat gerakan menyikat gigi yang digunakan. Hasil pengamatan dimasukkan ke dalam check list sesuai dengan teknik yang digunakan. Resesi gingiva yang diperoleh melalui pemeriksaan langsung diklasifikasikan menurut tingkat keparahan resesi gingiva. Jumlah responden dalam penelitian ini sebanyak 43 orang. Hasil analisis menggunakan uji Kolmogorov-Smirnov mendapatkan nilai p=0,000. Simpulan penelitian ini menunjukkan adanya hubungan teknik menyikat gigi dengan keparahan resesi gingiva.Kata kunci: resesi gingiva, teknik menyikat gigi


2016 ◽  
Vol 73 (4) ◽  
pp. 325
Author(s):  
Gabriela Alessandra Da C. Galhardo Camargo ◽  
Mariana Gouvea Latini Abreu ◽  
Renata Dos Santos ◽  
Marcio Alves Crespo ◽  
Leticia De Faria Wenderoscky

Objective: the aim of this study was to evaluate, through literature review, clinical aspects (plaque index, gingival index, probing depth, gingival recession and clinical attachment level) and microbiological (qualitative and quantitative presence of periodontal pathogens) in smokers patients and the response to periodontal therapy. Material and Methods: it was selected scientific articles published between the years 1978 and 2014. We were selected scientific articles from MEDLINE, PUBMED and LILACS databases. Results: there are controversies between tobacco and clinical and microbiological parameters. Conclusion: based on the evaluated studies we can conclude that there are significant clinical and microbiological differences in smoking patients and impaired response to periodontal therapy.


2016 ◽  
Vol 04 (01) ◽  
pp. 059-064
Author(s):  
Preetinder Singh ◽  
Yash Dev ◽  
Khuller Nitin ◽  
Anahita Singh ◽  
Prabhjot Kaur ◽  
...  

AbstractGingival recession has been defined as the term used to characterize the apical shift of the marginal gingiva from its normal position on the crown of the tooth to levels on the root surface beyond the cemento-enamel junction (CEJ). Numerous techniques have been developed for treatment of these defects including rotational and advanced gingival flaps, soft-tissue grafting procedures with autogenous and allograft materials. This paper illustrates a case report of 42-years-old male patient with a chief complaint of thermal root sensitivity in relation with front teeth of lower jaw and describes a technique to coronally advance the flap in combination with recombinant human platelet-derived growth factor-BB (rhPDGF-BB) (GEM 21S®) to treat multiple gingival recession defects. Patient was followed postoperatively, and healing was evaluated at 1, 3 and 6 months, with recession depth as the primary outcome measure. This case report revealed a favourable tissue response to GEM 21S® from both clinical and aesthetic points of view showing excellent plastic surgery results for gingiva.


2004 ◽  
Vol 12 (3) ◽  
pp. 250-255 ◽  
Author(s):  
Milena Guerreiro Marini ◽  
Sebastião Luiz Aguiar Greghi ◽  
Euloir Passanezi ◽  
Adriana Campos Passanezi Sant'Ana

The gingival recession was assessed in 380 adult individuals aged more than 20 years and comprised both subjects being treated and looking for treatment at Bauru Dental School. Clinical evaluation was conducted by a single examiner in all teeth and involved analysis of four dental aspects (mesial, buccal, distal and lingual). The gingival recession was regarded as present whenever more than 1mm of root surface was exposed, and its vertical width was measured in millimeters from the cementoenamel junction to the gingival margin. The recessions were further scored following the criteria suggested by Miller in 1985. Gingival recession was observed in at least one dental surface in about 89% of the individuals analyzed. The prevalence, extension and severity of this clinical aspect increased with age. Class I recessions were the most frequent, yet there was a gradual increase of Class III and IV recessions as older subjects were evaluated. The mandibular teeth displayed more surfaces with gingival recession than the maxillary teeth and the mandibular incisors were the most affected teeth. Such high prevalence of gingival recession in adult patients demonstrates that dental professionals should provide attention to the clinical relevance of such alterations, as well as to the diagnosis of the etiologic factors.


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