Podcast
Questions and Answers
What is the definition of gingival recession?
What is the definition of gingival recession?
Which of the following best describes the clinical appearance of gingival recession?
Which of the following best describes the clinical appearance of gingival recession?
What are the mechanical factors that can contribute to gingival recession?
What are the mechanical factors that can contribute to gingival recession?
In evaluating the causative factors of gingival recession, which category does aggressive tooth brushing fall under?
In evaluating the causative factors of gingival recession, which category does aggressive tooth brushing fall under?
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Which aspect is NOT relevant to the measurement and monitoring of gingival recession?
Which aspect is NOT relevant to the measurement and monitoring of gingival recession?
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What should be considered when diagnosing the underlying causes of gingival recession?
What should be considered when diagnosing the underlying causes of gingival recession?
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What is typically the most immediate oral health impact of gingival recession on the dental patient?
What is typically the most immediate oral health impact of gingival recession on the dental patient?
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Which treatment modality is least likely to be effective in managing gingival recession caused by mechanical factors?
Which treatment modality is least likely to be effective in managing gingival recession caused by mechanical factors?
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What is a consequence of a marked frenal attachment?
What is a consequence of a marked frenal attachment?
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What is a characteristic of gingival biotype?
What is a characteristic of gingival biotype?
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Which factor does NOT contribute to gingival recession?
Which factor does NOT contribute to gingival recession?
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What indicates periodontal disease?
What indicates periodontal disease?
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What is a recognized risk when treating periodontal disease?
What is a recognized risk when treating periodontal disease?
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How do lower incisors impact upper incisors in a traumatic incisal relationship?
How do lower incisors impact upper incisors in a traumatic incisal relationship?
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Which of the following is NOT classified as an inflammatory factor in recession?
Which of the following is NOT classified as an inflammatory factor in recession?
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How can periodontal treatment impact gingival health?
How can periodontal treatment impact gingival health?
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How does smoking affect periodontal health?
How does smoking affect periodontal health?
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What is a potential consequence of poor marginal fit of restorations?
What is a potential consequence of poor marginal fit of restorations?
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What type of orthodontic movement is most likely to cause gingival recession in patients with a thin biotype?
What type of orthodontic movement is most likely to cause gingival recession in patients with a thin biotype?
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What condition can result from gingival recession that exposes the dentine root surface?
What condition can result from gingival recession that exposes the dentine root surface?
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What is crucial to consider before performing composite restorations in the cervical region?
What is crucial to consider before performing composite restorations in the cervical region?
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Which aesthetic issue is commonly associated with gingival recession?
Which aesthetic issue is commonly associated with gingival recession?
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What is a significant risk associated with exposed root surfaces due to gingival recession?
What is a significant risk associated with exposed root surfaces due to gingival recession?
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Which surgical method is associated with the surgical treatment of gingival recession?
Which surgical method is associated with the surgical treatment of gingival recession?
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What should be recorded to monitor gingival recession effectively?
What should be recorded to monitor gingival recession effectively?
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Which of the following is NOT an impact of gingival recession?
Which of the following is NOT an impact of gingival recession?
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Which of the following is NOT a common factor associated with gingival recession?
Which of the following is NOT a common factor associated with gingival recession?
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What process may occur in the pulp due to dentine hypersensitivity from recession?
What process may occur in the pulp due to dentine hypersensitivity from recession?
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What is essential to remember about the occurrence of periodontal disease?
What is essential to remember about the occurrence of periodontal disease?
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Which of the following treatments is specifically mentioned for addressing gingival recession?
Which of the following treatments is specifically mentioned for addressing gingival recession?
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What is the primary goal in monitoring gingival recession?
What is the primary goal in monitoring gingival recession?
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In the context of jaw surgery, what is a challenge associated with complex periodontal procedures?
In the context of jaw surgery, what is a challenge associated with complex periodontal procedures?
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What is the primary consequence of food stagnation in dentistry?
What is the primary consequence of food stagnation in dentistry?
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What does recession measurement involve?
What does recession measurement involve?
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Which of the following is NOT a causative factor of dental issues?
Which of the following is NOT a causative factor of dental issues?
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In managing recession, what is a primary focus when recording the condition?
In managing recession, what is a primary focus when recording the condition?
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Traumatic factors that contribute to dental issues include which of the following?
Traumatic factors that contribute to dental issues include which of the following?
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What role do periodontal indices play in dental assessment?
What role do periodontal indices play in dental assessment?
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Which factor is associated with food stagnation and its impact on oral health?
Which factor is associated with food stagnation and its impact on oral health?
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How should patients be educated about managing dental recession?
How should patients be educated about managing dental recession?
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What is Clinical Loss of Attachment (CLOA) also known as?
What is Clinical Loss of Attachment (CLOA) also known as?
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What is one of the first steps in managing a patient with recession?
What is one of the first steps in managing a patient with recession?
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Which of the following is NOT a treatment modality for clinical symptoms?
Which of the following is NOT a treatment modality for clinical symptoms?
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What should be monitored in patients with gingival recession?
What should be monitored in patients with gingival recession?
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What is a gingival veneer primarily used for?
What is a gingival veneer primarily used for?
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What might be recommended alongside appropriate oral hygiene aids?
What might be recommended alongside appropriate oral hygiene aids?
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Miller’s Classification is associated with which aspect of dental care?
Miller’s Classification is associated with which aspect of dental care?
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What is the purpose of measuring and recording recession in patients?
What is the purpose of measuring and recording recession in patients?
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Study Notes
Gingival Recession
- Gingival recession is the displacement of the gingival margin apically to the cemento-enamel junction, exposing the root surface.
- The aim of the study is to provide a comprehensive understanding of the etiology, treatment, and management of gingival recession in patients.
- Intended learning outcomes include explaining the various etiological factors related to gingival recession, recognizing the oral health consequences of gingival recession on the patient, identifying methods for measuring and monitoring gingival recession, and identifying different treatment approaches for gingival recession.
- GDC learning outcomes 1.1.2, 1.1.4, 1.1.8, 1.7.7, 1.10.1, 1.10.2, 1.10.3, 1.10.4, and 1.10.6 are relevant to this topic.
Mechanical Factors
- The mechanical factors associated with gingival recession include toothbrush trauma, traumatic incisor relationship, trauma from foreign bodies, and abnormal frenum attachments.
Toothbrush Trauma
- Prolonged aggressive tooth brushing techniques are a contributing factor.
- Inappropriate oral hygiene aids often combine with this factor.
Trauma from Foreign Bodies
- Examples include lower lip piercings and tongue piercings.
Traumatic Incisor Relationship
- The bite occurs such that the lower incisors impinge on the palatal aspect of the upper incisors.
Abnormal Frenum Attachments
- A tight frenum can produce an apical pull on the gingival tissues.
- This can make oral hygiene challenging and lead to localized periodontal problems and gingival recession.
Inflammatory Factors
- Gingival biotype, periodontal disease, smoking, poor marginal fit of restorations, and orthodontic tooth movement are factors contributing to inflammation and/or gingival recession.
Gingival Biotype
- Gingival tissue often appears delicate and translucent.
- The tissue may be friable with a minimal zone of attached gingiva.
Periodontal Disease
- Apical migration of the gingival margin is a notable sign of periodontal disease.
Smoking
- Smokers are generally more susceptible to periodontal disease.
- Smoking has a profound impact on the periodontal health of a patient and can accelerate gingival recession and worsen outcomes.
Poor Marginal Fit of Restorations
- Low-grade irritation from sub-gingival margins can encroach upon the biological width of the gingival tissues.
- This can potentially lead to plaque stagnation and gingival recession.
Orthodontic Tooth Movement
- Orthodontic movement can cause gingival recession, particularly in patients with a thin gingival biotype, especially during rapid orthodontic treatment.
Impact on the Patient
- Dentine hypersensitivity, aesthetic considerations, root caries, comfort issues such as food trapping, and difficulties speaking are all potential consequences of gingival recession
- Hypersensitivity from exposed root surfaces following recession is a common issue.
- A patient's aesthetics, confidence, and ability to speak may be impaired.
Treatment Modalities
- Treatment may include periodontal treatment, desensitizing agents, gingival veneers, composite restorations, and surgical intervention.
Gingival Veneer
- A removable acrylic facing that enhances aesthetics in patients with significant gingival recession.
Restorations
- Composite restorations are applied to cover sensitive, caries-prone exposed dentine in the cervical areas.
Gingival Graft Surgery
- Complex periodontal surgical procedures can involve transplanting palatal gingival tissue.
- This procedure often has limited compliance and success rates.
Monitoring Gingival Recession
- All points of recession should be documented, monitored, and used to tailor the treatment approach.
Classification of Recession (Miller's Classification)
- Class I: Recession does not extend to the mucogingival junction with no loss of interdental bone or soft tissue.
- Class II: Recession extends to or beyond the mucogingival junction, with no loss of interdental bone or tissues.
- Class III: Recession extends to or past the mucogingival junction, with loss of interdental bone or tissue coronal to the apical extent of the recession.
- Class IV: Recession extends past the mucogingival junction, with loss of bone or soft tissue at or apical to the extent of the recession.
Management of Gingival Recession
- Patient education, monitoring, reduction of habitual risk factors, periodontal stabilization, and if necessary, a decision to do nothing or stabilize treatment.
Advice to the Patient
- Tooth brushing methods, oral hygiene aids, application of adjuvants for sensitivity, and a review of habitual factors are advised to the patient.
Treatment Modalities for Clinical Symptoms
- Periodontal treatment, desensitizing agents, gingival veneers, composite restorations, and referrals for surgical interventions are potential treatment options depending on the patient's needs.
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