Gingival Recession Overview
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Questions and Answers

What is the primary factor that must be maintained while measuring recession at the Cement Enamel Junction (CEJ)?

  • The probe should be held at an angle of 45 degrees
  • The probe must be kept parallel to the long axis of the tooth (correct)
  • The probe should be slightly curved for increased accuracy
  • The angle of the probe should be perpendicular to the tooth
  • How is Loss of Attachment (LOA) quantified?

  • By using only clinical attachment loss measurements
  • Through visual assessment of gum health
  • As a function of probing depth alone
  • By combining recession measurements with probing depth (correct)
  • What should be done immediately after noting recession in a patient?

  • Measure and record, followed by education about causes (correct)
  • Monitor the condition without taking any action
  • Immediately refer the patient to a specialist
  • Inform and educate the patient only
  • Which term is NOT synonymous with Loss of Attachment (LOA)?

    <p>Gingival margin recession (GMR) (D)</p> Signup and view all the answers

    In Miller’s Classification of Recession, which aspect is primarily focused on?

    <p>The severity and extent of marginal tissue loss (C)</p> Signup and view all the answers

    What is the primary purpose of applying a gingival veneer in patients with advanced and generalized recession?

    <p>To improve aesthetics and cover exposed dentine (D)</p> Signup and view all the answers

    Why is case selection considered vital when recommending composite restorations?

    <p>It addresses sensitivity issues in exposed dentine (A)</p> Signup and view all the answers

    Which approach should be taken to manage gingival recession without any immediate intervention?

    <p>Educate patients and monitor their habits (C)</p> Signup and view all the answers

    What additional recommendations should be provided to patients experiencing tooth sensitivity?

    <p>Use desensitizing agents and appropriate oral hygiene aids (C)</p> Signup and view all the answers

    What role does the coaching of tooth brushing technique play in the management of gingival recession?

    <p>It contributes to the stabilization of periodontal health (A)</p> Signup and view all the answers

    What is a significant consequence of poor marginal fit of restorations?

    <p>Encroachment on biologic gingival width (C)</p> Signup and view all the answers

    What effect does smoking have on periodontal health?

    <p>It significantly impairs periodontal status. (B)</p> Signup and view all the answers

    Which of the following is a result of orthodontic movement in patients with thin biotypes?

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

    What is a potential aesthetic concern related to gingival recession?

    <p>Formation of black triangles (B)</p> Signup and view all the answers

    How is dentine hypersensitivity related to gingival recession?

    <p>It is caused by exposure of the dentine root surface (D)</p> Signup and view all the answers

    What risk is increased due to exposed root surfaces from gingival recession?

    <p>Root caries (D)</p> Signup and view all the answers

    What is a potential consequence of gingival recession affecting food intake?

    <p>Discomfort from food trapping (C)</p> Signup and view all the answers

    What can hyperaemia of the pulp result from in terms of dental issues?

    <p>Exposure of root surfaces (B)</p> Signup and view all the answers

    What is the relationship described when lower incisors impact palatally of the upper incisors?

    <p>Traumatic incisal relationship (C)</p> Signup and view all the answers

    Which of the following factors is associated with localized periodontal issues due to marked frenal attachments?

    <p>Oral hygiene difficulty (D)</p> Signup and view all the answers

    What should patients be warned about when undergoing treatment for periodontal disease?

    <p>Risks of iatrogenic damage (B)</p> Signup and view all the answers

    Which gingival biotype is characterized by delicate, translucent tissue and minimal attached gingiva?

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

    What sign is commonly associated with periodontal disease concerning the gingival margin?

    <p>Apical migration of gingival margin (D)</p> Signup and view all the answers

    Which of the following is NOT considered an aetiological factor behind recession?

    <p>Lack of dental care (D)</p> Signup and view all the answers

    How can smoking contribute to periodontal issues?

    <p>Increasing inflammation and recession (A)</p> Signup and view all the answers

    Which of the following statements is true regarding the effects of orthodontic tooth movement?

    <p>It may contribute to the development of gum recession. (D)</p> Signup and view all the answers

    What is one consequence of food stagnation in dental hygiene?

    <p>It can lead to discomfort for the patient. (C)</p> Signup and view all the answers

    Which type of trauma is associated with recession due to toothbrush usage?

    <p>Mechanical trauma from brushing. (B)</p> Signup and view all the answers

    Which of the following is considered an iatrogenic factor in tooth recession?

    <p>Poor marginal fit of restorations. (C)</p> Signup and view all the answers

    What is the role of a dental professional in managing traumatic recession?

    <p>Provide recommendations to stabilize and halt further recession. (B)</p> Signup and view all the answers

    What should be measured to monitor gingival recession effectively?

    <p>Distance from the gum line to the crown margin. (B)</p> Signup and view all the answers

    Which factor is NOT typically associated with recession due to poor oral hygiene?

    <p>Consumption of can sugary beverages. (D)</p> Signup and view all the answers

    How does the shape of the gingival biotype relate to recession?

    <p>Thick biotypes are less susceptible to recession. (B)</p> Signup and view all the answers

    What should be done when educating patients about the risks of recession?

    <p>Reiterate the importance of proper oral hygiene practices. (B)</p> Signup and view all the answers

    What is the primary purpose of monitoring gingival recession in patients?

    <p>To record recession points and respond to treatment needs (D)</p> Signup and view all the answers

    Which factors are most commonly associated with gingival recession (GR)?

    <p>Inflammatory and mechanical factors (D)</p> Signup and view all the answers

    What is required for successful gingival graft surgery?

    <p>Adequate compliance and a suitable technique involving palatal tissue (C)</p> Signup and view all the answers

    What is NOT a consideration when performing periodontal surgery?

    <p>Patient's preference for treatment location (A)</p> Signup and view all the answers

    Which statement best describes the general population at risk for periodontal disease?

    <p>All individuals with teeth, including pets, can develop periodontal disease (A)</p> Signup and view all the answers

    What is a critical step to take when measuring gingival recession (GR)?

    <p>Perform a comprehensive oral examination to assess overall health (C)</p> Signup and view all the answers

    Which treatment modality is commonly used for addressing gingival recession?

    <p>Gingival grafts from other areas (D)</p> Signup and view all the answers

    What is an important factor for assessing treatment needs for gingival recession?

    <p>Extent of gingival recession and its impact on the patient (B)</p> Signup and view all the answers

    Flashcards

    Trauma from foreign bodies

    Damage to the mouth caused by objects like lip/tongue studs.

    Traumatic incisal relationship

    A bite where lower incisors hit the upper incisors, causing problems.

    Abnormal frenal attachments

    Unusual attachment of the frenum (tissue) causing pulling on the gums.

    Iatrogenic damage

    Damage caused by a dental procedure, typically involving recession.

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    Inflammatory factors

    Factors causing inflammation in the gums (like periodontal disease, etc).

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    Gingival biotype

    The type of gum tissue, with differences in thickness and resilience.

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    Periodontal disease

    Disease that results in receding gums and damage to the supporting tissues.

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    Apical migration

    The movement of the gum line away from the tooth root.

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    Recession

    The movement of the gum line away from the tooth, exposing more of the root.

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    Causative Factors

    The reasons why recession occurs, such as toothbrushing, trauma, or inflammation.

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    Mechanical Factors

    Physical forces that contribute to recession, like aggressive brushing or piercings.

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    Toothbrush Trauma

    Injury to the gums caused by improper brushing technique.

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    Foreign Body Trauma

    Damage to the gums from objects like jewelry or piercings.

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    Stabilize Recession

    Stopping or preventing further gum recession.

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    Smoking's effect on periodontal health

    Smokers are more likely to develop periodontal disease.

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    Poor restoration fit

    Improperly fitted dental restorations can irritate gums and lead to plaque buildup from the subgingival margins, encroaching on the gingival width.

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    Orthodontic movement and recession

    Fast orthodontic movements in patients with thin gums can cause gum recession.

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    Gingival recession impact

    Gingival recession leads to potential issues like tooth sensitivity, aesthetics concerns, and a higher risk of cavities because of the exposed root surface.

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    Dentin hypersensitivity

    Exposed dentin from gum recession causes sensitivity to hot, cold, and certain foods due to the lack of enamel.

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    Aesthetic problems from recession

    Gingival recession can create "black triangles" which are unwanted aesthetic problems.

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    Root caries risk

    Exposed roots are more susceptible to decay due to their lower mineral content compared to enamel.

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    Critical pH for caries

    Specific pH values affect tooth decay rates, for which enamel requires a different pH value than dentine.

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    Loss of Attachment (LOA)

    Combines recession and probing depth to measure how much tissue has been lost around a tooth.

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    How is LOA measured?

    It is a combination of recession and probing depth combined.

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    Miller's Classification

    A system used to categorize the severity of recession based on the location and extent of the gum recession.

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    What to do if you see recession?

    Monitor, refer, educate, treat, and identify the cause.

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    Gingival Veneer

    A removable acrylic covering used to improve the appearance of teeth with significant gum recession.

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    Composite Restorations

    A tooth-colored filling placed to cover exposed dentin, protecting it from sensitivity and decay.

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    Why is Case Selection Important?

    Choosing the right treatment for gingival recession depends on the severity, patient's health, and desired outcome.

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    Habitual Factors in Recession

    Daily habits like aggressive brushing or using a hard toothbrush can contribute to gum recession.

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    Desensitizing Agents

    Products used to reduce tooth sensitivity caused by exposed dentin from recession.

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    What is a gingival graft?

    A surgical procedure where gum tissue is transplanted to cover a receding gum line.

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    What are some complex periodontal surgeries?

    Advanced procedures addressing gum problems, often involving tissue transplants and multiple steps.

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    Why are some periodontal surgeries limited?

    Complex procedures may have lower success rates and patient compliance due to their complexity and recovery requirements.

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    How do the techniques of complex periodontal surgery differ?

    They can involve transplanting gum tissue from the palate, aiming to restore gums around the tooth.

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    What is 'monitoring gingival recession'?

    Regular checking for gum recession and responding appropriately, often involving treatment or referral to a specialist.

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    What factors influence the success of complex periodontal surgery?

    Factors like patient compliance, the severity of the problem, and the patient's overall health can affect the outcome.

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    What is the impact of gingival recession?

    It can expose tooth roots leading to sensitivity, affect tooth stability, and increase risk of tooth decay.

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    What does a healthy mouth look like?

    Gums that are firm, pink, and tightly fit around the teeth, with no visible root.

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    Study Notes

    Gingival Recession

    • Gingival recession is the displacement of the gingival margin apically to the cemento-enamel junction, leading to root surface exposure.

    Intended Learning Outcomes

    • Understand the various factors contributing to gingival recession, including aetiology (causes).
    • Recognize the oral health impact on the dental patient due to recession.
    • Learn methods for measuring and monitoring recession.
    • Identify different treatment options for gingival recession.

    Definition

    • Gingival recession is the apical displacement of the gingival margin relative to the cemento-enamel junction, exposing the root surface.

    Revision of Healthy Gingival Tissues

    • Alveolar mucosa, mucogingival junction, attached gingiva, free gingiva, interdental papilla, and stippling are parts of healthy gingival tissue
    • Free gingiva + Attached gingiva = Keratinized Tissue (KT)

    Clinical Appearance

    • Determine if gingival recession is localized or generalized.

    Recession

    • Usually, recession is confined to one aspect (labial or buccal) of a tooth.
    • Recession doesn't automatically compromise periodontal support.
    • Underlying causes of recession need to be considered.

    Causative Factors of Gingival Recession

    • Mechanical factors (e.g., toothbrush trauma, traumatic incisor relationship, trauma from foreign bodies, abnormal frenum attachment, iatrogenic damage)
    • Inflammatory factors (e.g., gingival biotype, periodontal disease, smoking, poor marginal fit of restorations, orthodontic tooth movement).

    Mechanical Factors

    • Toothbrush trauma (aggressive brushing technique, inappropriate oral hygiene aids)
    • Traumatic incisor relationship (lower incisors impacting the upper incisors)
    • Trauma from foreign bodies (e.g., lip or tongue studs)
    • Abnormal frenum attachment (apical pull on gingival tissues, hindering oral hygiene)
    • Iatrogenic damage (damage during dental procedures)

    Toothbrush Trauma

    • Prolonged aggressive brushing technique is a major cause
    • Often coupled with improper oral hygiene aids

    Trauma from Foreign Bodies

    • Examples include lower lip studs and tongue studs

    Traumatic Incisal Relationship

    • The bite is characterized by lower incisors impacting palatally against the upper incisors

    Abnormal Frenum Attachments

    • A pronounced frenum attachment can exert an apical pull on the gingival tissues, making oral hygiene difficult, and leading to localized periodontal issues and recession.

    Iatrogenic Damage

    • A known risk relating to successful periodontal treatment
    • Patients should be cautioned about the effects of recession during periodontal treatments

    Inflammatory Factors

    • Gingival biotype (delicate, translucent tissue is more susceptible)
    • Periodontal disease (apical migration of the gingival margin)
    • Smoking (affects periodontal status, increasing susceptibility to periodontal disease)
    • Poor marginal fit of restorations (low-grade irritant, subgingival margins)
    • Orthodontic tooth movement (accelerated movement)

    Gingival Biotype

    • Delicate and almost translucent appearance.
    • Minimal attached gingiva.
    • Friable tissue.

    Periodontal Disease

    • Apical migration of the gingival margin is a common indicator.

    Smoking

    • Smoking has a detrimental impact on periodontal health and increases susceptibility to periodontal disease.

    Poor Marginal Fit of Restorations

    • Low-grade irritant from sub-gingival margins can impinge on the biologic width.
    • Potential for plaque stagnation.
    • Contributing factor for recession in susceptible patients.

    Orthodontic Movement

    • Tooth movement may cause gingival recession, especially in thin tissue biotypes during rapid orthodontic procedures in adults.

    Impact of Gingival Recession on the Patient

    • Dentine hypersensitivity
    • Aesthetic concerns
    • Root caries
    • Food trapping
    • Plaque stagnation
    • Difficulty with comfort (e.g., eating)

    Dentine Hypersensitivity

    • Recession exposes dentine.
    • Hyperaemia of pulp may also result.

    Aesthetic Considerations

    • Risk of poor aesthetics.
    • Black triangles.

    Root Caries

    • Exposed root surface is less mineralised and more susceptible to caries than enamel

    Plaque Stagnation and Food Trapping

    • Poor oral hygiene can lead to food and plaque stagnation in recessed areas.
    • Recommending appropriate oral hygiene aids is important.

    Summary of Causative Factors

    • Provide descriptions of each causative factor.
    • Explain how they cause recession.
    • Explain the consequences of recession and related risks

    Measuring and Monitoring Recession

    • Measure distance from the cemento-enamel junction (CEJ) to the gingival margin.
    • Ensure the probe is held parallel to the long axis of the tooth.
    • Use a probe with clear markings

    Loss of Attachment (LOA)

    • Combined effect of recession and probing depth.
    • Sometimes referred to as clinical loss of attachment (CLOA) or clinical attachment loss (CAL).

    Recession in the Patient

    • Steps to identifying, monitoring, and treating recession:
    • Refer patient.
    • Inform patient
    • Monitor.
    • Identify underlying cause.
    • Treat as needed.
    • Measure and record the recession.
    • Educate the patient.

    Miller's Classification of Recession

    • Different classifications based on extent of recession: Class I, II, III, IV
    • Descriptions for each class include the location of recession relative to the mucogingival junction, and the loss (or absence of loss) of interdental bone or soft tissue.

    Management of Gingival Recession

    • Patient education
    • Monitoring
    • Reduction of habitual factors
    • Periodontal stabilisation
    • Do nothing and stabilize (treatments may be used)

    Advice to Patient

    • Tooth brushing technique coaching with appropriate oral hygiene aids.
    • Recommending appropriate adjuncts for sensitivity (e.g., desensitizing agents).
    • Habitual advice.

    Treatment Modalities for Clinical Symptoms

    • Periodontal treatment.
    • Desensitizing agents.
    • Gingival veneers.
    • Composite restorations.
    • Referral for surgical intervention

    Gingival Veneer

    • Removable acrylic facing that improves aesthetics for advanced/generalized recession cases.
    • Case selection is crucial.

    Restorations

    • Composite restorations to protect exposed dentin (especially in cervical regions), which is sensitive and prone to caries.
    • Case selection is crucial.

    Gingival Graft Surgery

    • Complex periodontal surgery procedure.
    • Involves transplanting palatal gingival tissue to the affected site.

    Monitoring Gingival Recession

    • Record all recession points.
    • Monitor and respond to treatment needs accordingly.
    • Refer to specialist as necessary.

    Summary Revision Slide

    • Include a summary of gingival recession definitions.
    • Discuss measurement of recession/loss of attachment (LOA).
    • Include descriptions of all causative factors (mechanical and inflammatory).
    • Discuss the impact on the patient.
    • Discuss treatment modalities.

    References

    • The references provided are related to treatment recommendations, studies regarding gingival recession, along with other related topics in periodontics. Each reference is associated with a research study or publication supporting the study conclusions.

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    Gingival Recession PDF

    Description

    This quiz covers the essential aspects of gingival recession, including its definition, causes, and clinical implications. Participants will learn about the impact of recession on oral health and explore various treatment options. Test your knowledge on how to measure and monitor gingival condition.

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