1. GINGIVAL RECESSION

2. R O A D M P DEFINITION CLASSIFICATION FACTORS PROCESS OF RECESSION
PROGRESSION
SYMPTOMS
TREAMENT
PREVENTION

3. 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.

4. B A S I C R E V W
MARGINAL GINGIVA + ATTACHED GINGIVA= KERATINIZED GINGIVA
ALVEOLAR MUCOSA
MARGINAL /ATTACHED = FREE GINGIVAL GROOVE
ATTACHED/ ALVEOLAR MUCOSA= MUCOGINGIVAL JUNCTION

5. MILLAR’S CLASSIFICATION OF GINGIVAL RECESSION:

6. CLASS II
CLASS II

7. `
CLASS III

8. C L A S IV

9. SALLIVAN & ATKINS: (1968) Shallow narrow Deep narrow Shallow wide
Deep wide

10. ETIOLOGY DETERMINANT 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
ETIOLOGY

11. INADEQUATE ATTACHED GINGIVA
LIP & TONGUE PIERCING
PARTIAL DENTURE CLASP
INADEQUATE ATTACHED GINGIVA
AMALGAM OVERHANGS

12. CO FACTORS Tooth Malposition Unfavorable Anatomy Orthodontic Movements
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

13. STILLMAN’S CLEFT

14. PATHOGENESIS

15. PROGRESSION OF RECEDING GUMS
• 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

16. 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)

17. TREATMENT
Cause-specific treatment in non-progressive gingival recession
Surgical root coverage in progressive gingival recession.

18. OBJECTIVES: Problems associated with attached gingiva
Problems associated with shallow vestibule
Problems associated with aberrant frenum

19. “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