Gingival recession part 2. surgical management

Surgical procedure to fix gum recession defects. It aims to improve aesthetics, reduce sensitivity, and prevent further recession.

A classification system categorizing gingival recession defects into four types (I-IV) based on severity and location.

Gum recession where only the root is exposed, no bone loss, and the interdental papilla is intact.

Gum recession extending beyond the interdental papilla, root exposed, but the bone is still intact.

Gum recession involving bone loss. The bone is below the cemento-enamel junction, and there might be root exposure extending to the interdental area.

Gum recession involving severe bone loss. The papilla is gone, the root is significantly exposed, and the teeth might even tilt.

Factors that influence the success of gum recession surgery.

In cases of severe gum recession due to chronic periodontal disease, surgery is usually not recommended due to likelihood of poor outcome and possible further damage.

A surgical technique where a flap of gum tissue is taken from one side of a recession defect and moved over the exposed root surface.

A type of pedicle flap where the flap is taken from the side of the recession defect and moved over the exposed root surface.

A modification of the pedicle flap where a thinner flap is taken and repositioned over the exposed root surface.

A specialized pedicle flap technique where the flap is taken from two sides of the recession defect and brought together over the exposed root surface.

The process of securing the pedicle flap in its new position.

Applying pressure to the pedicle flap to ensure good blood flow and prevent clots from forming.

The area where the pedicle flap was taken from.

Allows the donor site to heal naturally without stitches.

The layer of debris covering the root surface that needs to be removed for successful tissue attachment.

Citric acid can be used to clean this layer and help create a better surface for tissue connection.

The height of the recession, the area where gum has receded, is important for choosing the right surgical procedure. The amount of healthy gum tissue and the depth of the gum area near the teeth (vestibule) are all factors.

These flaps are essential for nourishing the grafted tissue during healing. It is not a good idea to use too thin flaps.

Flaps with a thickness of less than 1 mm can have a negative impact on the outcome of root coverage surgery. Thicker flaps are preferred to ensure enough blood supply to the grafted tissue.

A prominent frenectomy is a tight band of tissue that can pull on the gums and cause recession. Removing it can improve the success rate of periodontal surgery.

The ability of the grafted tissue to survive and thrive depends on a good blood supply from the surrounding tissue. A healthy flap contributes to this.

The thickness of the graft material should be sufficient to prevent tissue death (necrosis) during the healing process.

A surgical technique used to cover exposed tooth roots caused by gum recession. This involves repositioning gum tissue to cover the root surface.

A type of gum tissue that has a thin layer of surface tissue and is prone to recession.

A layer of gum tissue that is attached to the tooth and provides protection. Adequate keratinized tissue is essential for successful gum grafting.

A type of gum graft that involves taking tissue from one area of the mouth and transferring it to the area of the root.

A type of gum graft that involves taking connective tissue from the roof of the mouth and transplanting it to the recession area.

A type of suture that is placed around the tooth to help hold the grafted tissue in place and prevent it from moving.

A surgical technique that involves repositioning gum tissue over the exposed root surface in one step, without a prior graft, if the gum tissue is thick enough and there is adequate keratinized tissue.

A type of gingival recession defect where the recession is located on the facial aspect of the tooth and does not involve interdental papilla.

A type of gingival recession defect where the recession is located on the facial aspect of the tooth and extends to the interdental papilla.

The process of shaping or altering the surface of a tooth, usually by removing a small amount of enamel.

The process of applying a tooth-colored material to the surface of a tooth to improve its shape and appearance.

The process of removing a layer of soft tissue to expose the underlying bone. This is often done to prepare the area for a graft or other surgical procedures.

The process of removing a larger section of tissue in a surgical procedure.

The repositioned flap technique aims to shift the gum tissue back over exposed roots, improving aesthetics and protecting the root surface. It involves raising a flap of gum tissue, repositioning it coronally, and securing it in place with sutures.

The type of graft that is attached to the original tissue with a small part of the tissue to supply blood flow.

The thickness of the gum tissue plays a key role in choosing the best surgical approach for gum recession. Thin tissue may require different methods than thick tissue.

Periodontal plastic surgery, including the repositioned flap techniques and grafts, has shown promising results in reducing gum recession and improving attachment levels.

A single surgical procedure may not completely cover the recession. Continued improvements can be expected over time as the gum tissue heals and adapts.

The presence of sufficient keratinized tissue is important for the success of repositioned flap procedures. Insufficient tissue can make the procedure less effective or lead to complications.