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?

Tissue borne partial dentures Signup and view all the answers

What kind of trauma can potentially cause gingival recession?

Lower lip piercings Signup and view all the answers

What is primarily responsible for gingival recession?

Direct mechanical or physical influence Signup and view all the answers

Under what circumstances is treatment for gingival recession usually necessary?

When there is concern about aesthetics or sensitivity Signup and view all the answers

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

Non-surgical treatments can restore aesthetics Signup and view all the answers

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

Poor oral health practices Signup and view all the answers

What is an associated symptom in patients with gingival recession?

Dentine hypersensitivity Signup and view all the answers

How is gingival recession classified in patients?

As a common finding with variable concerns Signup and view all the answers

What is a common cause of gingival recession?

Thin gingival biotype Signup and view all the answers

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

Surgical options for localized recession defects Signup and view all the answers

How does periodontal disease contribute to gingival recession?

By causing loss of supporting bone Signup and view all the answers

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

Assessing the patient's aesthetic concerns and sensitivity Signup and view all the answers

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

1 mm distal to the midline Signup and view all the answers

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

Increased dentine hypersensitivity Signup and view all the answers

Which of the following conditions is associated with gingival recession?

Abrasive class V cavities Signup and view all the answers

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

Manage brushing trauma Signup and view all the answers

What is the significance of understanding the gingival zenith?

It is important for addressing aesthetic concerns Signup and view all the answers

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

Thick gingival biotype Signup and view all the answers

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

Class II Division 2 Signup and view all the answers

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

Localized recession Signup and view all the answers

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

High fraenal attachments Signup and view all the answers

What can cause recession as a result of iatrogenic damage?

Rough restoration surfaces Signup and view all the answers

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

Generalized signs of recession Signup and view all the answers

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

Bone resorption Signup and view all the answers

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

All surfaces Signup and view all the answers

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

Rough restoration surfaces Signup and view all the answers

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

Silicone putty Signup and view all the answers

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

Less flexibility Signup and view all the answers

Which of the following statements about silicone materials is true?

They have improved comfort. Signup and view all the answers

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

Petroleum jelly Signup and view all the answers

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

The maximum curvature of the teeth Signup and view all the answers

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

J Periodontol 1967 Signup and view all the answers

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

Increased resistance to fracture Signup and view all the answers

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

Making a gingival veneer Signup and view all the answers

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

To prevent further recession Signup and view all the answers

What do desensitizing agents and varnishes typically aim to treat?

Dentine hypersensitivity Signup and view all the answers

How do lasers work on dentine hypersensitivity?

By causing coagulation of proteins in the dentinal tubules Signup and view all the answers

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

There is limited long-term evidence Signup and view all the answers

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

They can enhance cosmetic appearance Signup and view all the answers

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

Thin biotype Signup and view all the answers

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

Enameloplasty Signup and view all the answers

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

Better dentine bonding techniques Signup and view all the answers

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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