Gingival recession part 1. Aetiology and non-surgical management

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Questions and Answers

What is a common cause of gingival recession related to tooth brushing techniques?

  • Rinsing with mouthwash
  • Vigorous brushing with a hard bristle toothbrush (correct)
  • Brushing only once a day
  • Using a soft bristle toothbrush

Where does gingival recession primarily manifest?

  • Occlusal surfaces
  • Buccal surfaces of individual teeth (correct)
  • Lingual surfaces of teeth
  • Interproximal areas

Which condition can result in localized areas of recession?

  • Buccal abrasion cavities (correct)
  • Using a water flosser
  • Flossing aggressively
  • Regular dental cleanings

What type of dental accessory can contribute to gingival stripping?

<p>Tissue borne partial dentures (C)</p> Signup and view all the answers

What kind of trauma can potentially cause gingival recession?

<p>Lower lip piercings (D)</p> Signup and view all the answers

What is primarily responsible for gingival recession?

<p>Direct mechanical or physical influence (B)</p> Signup and view all the answers

Under what circumstances is treatment for gingival recession usually necessary?

<p>When there is concern about aesthetics or sensitivity (D)</p> Signup and view all the answers

Which of the following statements is true regarding treatment options for gingival recession?

<p>Non-surgical treatments can restore aesthetics (D)</p> Signup and view all the answers

Which factor is NOT mentioned as a contributing factor to gingival recession?

<p>Poor oral health practices (B)</p> Signup and view all the answers

What is an associated symptom in patients with gingival recession?

<p>Dentine hypersensitivity (C)</p> Signup and view all the answers

How is gingival recession classified in patients?

<p>As a common finding with variable concerns (D)</p> Signup and view all the answers

What is a common cause of gingival recession?

<p>Thin gingival biotype (A)</p> Signup and view all the answers

What will subsequent papers in the series focus on regarding gingival recession?

<p>Surgical options for localized recession defects (C)</p> Signup and view all the answers

How does periodontal disease contribute to gingival recession?

<p>By causing loss of supporting bone (C)</p> Signup and view all the answers

Which of the following is a key aspect in the management of gingival recession?

<p>Assessing the patient's aesthetic concerns and sensitivity (A)</p> Signup and view all the answers

What is the ideal position of the gingival zenith for central incisors according to the study mentioned?

<p>1 mm distal to the midline (A)</p> Signup and view all the answers

What can be a result of gingival recession related to exposed root surfaces?

<p>Increased dentine hypersensitivity (A)</p> Signup and view all the answers

Which of the following conditions is associated with gingival recession?

<p>Abrasive class V cavities (C)</p> Signup and view all the answers

What should be managed to help alleviate sensitivity related to gingival recession?

<p>Manage brushing trauma (D)</p> Signup and view all the answers

What is the significance of understanding the gingival zenith?

<p>It is important for addressing aesthetic concerns (C)</p> Signup and view all the answers

Which type of gingival biotype is typically considered to be more resistant to recession?

<p>Thick gingival biotype (A)</p> Signup and view all the answers

Which dental class is associated with localized recession of the upper anterior teeth palatally?

<p>Class II Division 2 (B), Class II Division 1 (C)</p> Signup and view all the answers

What is a potential consequence of thin gingival biotype overlying alveolar dehiscence?

<p>Localized recession (D)</p> Signup and view all the answers

Which factor is considered a poor evidence contributor to gingival recession?

<p>High fraenal attachments (C)</p> Signup and view all the answers

What can cause recession as a result of iatrogenic damage?

<p>Rough restoration surfaces (D)</p> Signup and view all the answers

What is likely to occur in patients with high fraenal attachments near the gingival margin?

<p>Generalized signs of recession (B)</p> Signup and view all the answers

What is an effect of periodontal disease on bone support around the tooth?

<p>Bone resorption (C)</p> Signup and view all the answers

Which surface can show recession in patients with localized periodontal problems due to poor oral hygiene?

<p>All surfaces (D)</p> Signup and view all the answers

Which restoration characteristic can contribute to plaque accumulation, leading to recession?

<p>Rough restoration surfaces (C)</p> Signup and view all the answers

What material is used for the initial impression in creating a gingival prosthesis?

<p>Silicone putty (B)</p> Signup and view all the answers

What is a disadvantage of hard, ridged base materials compared to silicone base materials?

<p>Less flexibility (B), Lower comfort (D)</p> Signup and view all the answers

Which of the following statements about silicone materials is true?

<p>They have improved comfort. (A)</p> Signup and view all the answers

What is used as a separating medium before taking the impression?

<p>Petroleum jelly (A)</p> Signup and view all the answers

During the impression process, what must not be exceeded by the silicone putty?

<p>The maximum curvature of the teeth (A)</p> Signup and view all the answers

Which publication relates to the prevalence and etiology of gingival recession?

<p>J Periodontol 1967 (A)</p> Signup and view all the answers

What advantage do silicone base materials have over other impression materials?

<p>Increased resistance to fracture (B)</p> Signup and view all the answers

What is one of the uses of the two-part impression technique mentioned?

<p>Making a gingival veneer (B)</p> Signup and view all the answers

What is the main purpose of using lasers in periodontal treatment?

<p>To prevent further recession (C)</p> Signup and view all the answers

What do desensitizing agents and varnishes typically aim to treat?

<p>Dentine hypersensitivity (A)</p> Signup and view all the answers

How do lasers work on dentine hypersensitivity?

<p>By causing coagulation of proteins in the dentinal tubules (D)</p> Signup and view all the answers

What has been noted about the long-term evidence for laser treatment of dentine hypersensitivity?

<p>There is limited long-term evidence (A)</p> Signup and view all the answers

What is one of the benefits of using composite restorations in dentistry?

<p>They can enhance cosmetic appearance (C)</p> Signup and view all the answers

Which type of gingival biotype is particularly susceptible to plaque-induced inflammation?

<p>Thin biotype (A)</p> Signup and view all the answers

What dental procedure was performed to help even the incisal plane?

<p>Enameloplasty (A)</p> Signup and view all the answers

What recent advancement in dental materials is mentioned in relation to composite restorations?

<p>Better dentine bonding techniques (C)</p> Signup and view all the answers

Flashcards

Gingival Recession

The wearing away of gum tissue, exposing the tooth root.

Tooth Brushing and Recession

Vigorous brushing or using a hard-bristled toothbrush can cause gum recession, especially in people with good oral hygiene.

Thin Gingival Biotype

A thin layer of gum tissue, making it more vulnerable to recession.

Bone Dehiscence

A condition where bone supporting the tooth is missing, making it prone to recession.

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Traumatic Incisal Relationship

Traumatic biting forces can strip the gums, causing recession.

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Direct Mechanical Factors

Direct forces, like brushing too hard or using hard toothbrushes, can cause gingival recession.

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Indirect Factors

Factors that create an inflammatory environment in the gums, like plaque build-up, can also cause recession.

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Aetiology

The study of the causes of a disease or condition, like gingival recession.

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Treatment Necessity

Recession treatment might not be necessary if there are no aesthetic concerns or sensitivity issues.

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Non-Surgical Sensitivity Management

Options like toothpaste, mouthwash, or special gels, can help manage sensitivity.

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Non-Surgical Aesthetic Correction

Techniques like gum grafts or soft tissue surgery, can restore aesthetic appearance.

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Surgical Treatment Options

Recession can be corrected through a range of surgical procedures.

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Alveolar Dehiscence

A condition where the bone protecting the tooth root is missing, making the area more susceptible to gum recession.

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Aberrant Fraenal Attachment

A strong, tight attachment of the gum tissue to the tooth, potentially causing recession.

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High Fraenal Attachment

A condition where the gums are close to the tooth, making it difficult to brush properly and leading to plaque buildup and recession.

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Iatrogenic Damage

Poorly fitted dental restorations, such as crowns, can trap plaque and bacteria, ultimately causing gum recession.

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Periodontal Disease

An inflammatory process caused by bacteria, leading to gum recession and bone loss.

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Iatrogenic Recession

Recession caused by factors related to the dental work performed, such as poorly fitted restorations or rough surfaces.

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Tooth Brushing Trauma

Recession caused by vigorous tooth brushing, using hard-bristled brushes, or aggressive flossing.

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Bone Loss

A factor in gum recession that involves the loss of bone around a tooth, usually caused by periodontal disease.

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Dentine Hypersensitivity

Tooth sensitivity resulting from exposed root surfaces during gum recession.

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Gingival Zenith

The highest point of the gum margin around a tooth, often used to assess the position of gum tissue.

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Ideal Gingival Zenith Position

An ideal position of the gingival zenith when it is slightly distal to the vertical midline of a tooth.

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What makes thin gingival biotypes more vulnerable to recession?

A thin layer of gum tissue, making it more prone to recession.

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What is enameloplasty?

The procedure of reshaping the biting edge of teeth to create a more even and aesthetically pleasing smile.

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What are desensitizing agents used for?

A substance used to reduce sensitivity in the teeth.

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What are composite restorations?

A special type of tooth filling material that is used to bond directly to the tooth.

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What is the purpose of gingival zenith leveling?

A dental procedure where the gingival zeniths are brought to a more even level.

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What is a gum graft?

A dental procedure that involves grafting tissue from one part of the mouth to another to treat gum recession.

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What is composite resin?

A type of advanced tooth filling material that closely resembles natural tooth enamel.

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What is enameloplasty used for?

A procedure used to reshape the tooth and create a new, smoother surface.

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Two Part Impression Technique

A two-part impression technique using silicone putty to create a model of the gum tissue and affected teeth, allowing for fabrication of a custom-made gingival prosthesis.

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Gingival Prosthesis

A flexible prosthetic device that replaces missing gum tissue, restoring aesthetic appearance and protecting exposed tooth roots.

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Silicone Base Material

This material is preferred for gingival prosthesis construction due to its flexibility, comfort, and resistance to fracture.

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Dentine

The outermost layer of the tooth that is sensitive to touch and temperature changes.

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Potassium Containing Toothpastes

These toothpastes are often used to manage dentine hypersensitivity by blocking nerve endings in the exposed dentine.

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Study Notes

Gingival Recession: Aetiology and Non-Surgical Management

  • Gingival recession is the displacement of the gingival tissue margin apically to the cemento-enamel junction, exposing the root surface.
  • Prevalence increases with age, occurring in both good and poor oral hygiene and periodontal disease.
  • Aetiology includes both direct mechanical/physical factors and indirect inflammatory reactions.

Mechanical/Physical Factors

  • Vigorous tooth brushing: Especially with hard-bristled brushes, localizing to buccal surfaces and often in individuals with good oral hygiene.
  • Traumatic incisal relationships: Akerly classification details four relationships, with Class II Div 1/2 and III/IV potentially causing recession (e.g., mandibular incisors impinging on maxillary gingival margin).
  • Trauma from foreign bodies: Examples include lip piercings and poorly designed partial dentures.
  • Prominent/misaligned teeth: Alveolar dehiscence (bone loss) contributing, especially with thin gingival biotype.

Inflammatory Factors

  • Gingival biotype: Thin gingival tissues are more susceptible to recession due to inflammation.
  • Periodontal disease: Apical migration caused by inflammation. Generally generalized recession across teeth surfaces (buccal, interproximal, palatal).
  • Poor marginal fit of restorations: Plaque traps causing inflammation and subsequent recession.
  • Orthodontic tooth movement: Labial movement outside alveolar bone envelope causes bone loss and reduced gingival thickness, predisposing to recession.

Patient Complaints/Concerns

  • Aesthetic concerns: Uneven gingival zeniths, black triangles.
  • Sensitivity: Exposed root surfaces.
  • Potential tooth loss: Associated with generalized periodontal issues.

Non-Surgical Treatment Options

  • Monitoring/Prevention: Managing the underlying causes of recession.
  • Desensitizing agents/varnishes/dentine bonding agents: Used to treat dentine hypersensitivity.
  • Composite restorations: Suitable for small, localized cases (recession, sensitivity, or caries).
  • Pink porcelain/composites: Used to address significant aesthetic concerns, replacing gingival tissue.
  • Removable gingival veneers: Suitable for more extensive recession in anterior regions.
  • Orthodontics: Used to reposition teeth, potentially correcting buccal dehiscence and improving gingival health.

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