Gingival recession , also known as gums at low tide , is exposure to the tooth root caused by loss of gum tissue and/or retracting gingival margins from the crown. of the teeth. Gum recession is a common problem in adults over the age of 40, but can also occur from adolescence, or around the age of 10 years. There may be with or without a decrease in the crown-to-root ratio (alveolar bone recession).
Video Gingival recession
Classification
Various classifications have been proposed to classify gingival recessions, the Miller classification system being one of the most widely followed. Many cases encountered in day-to-day clinical practice can not be classified according to the criteria of the current classification system. Kumar & amp; The Masamatti classification system provides a comprehensive overview of the recession defects that can be used to include cases that can not be classified according to the current classification. A separate classification system for palatal recession (PR) has been provided. A new classification system that comprehensively classifies recessions based on interdental and buccal/lingual/palatal recipient positions. Kumar & amp; Masamatti's classification system tries to overcome the limitations of Miller's classification.
Maps Gingival recession
Cause
There are many possible causes of gingival recession:
- By far the most common cause is gum disease (periodontal disease). Excessive scrubbing is often thought to lead to gum recession, but a systematic review of the literature concludes that "Data to support or disprove the link between toothbrushing and gingival recession can not be inferred." A subsequent study found a horizontal brushing technique (compared to Bass techniques or circular methods), the use of medium-toothbrush and brushing once a day was associated with a gingival recession.
- An improper thread (ie, too coarse or aggressive flossing) that can cut the gums.
- Hereditary, fragile or inadequate gingival tissue predisposes to gingival recession.
- Dipping tobacco, which affects the lining of the mucous membrane in the mouth and will cause gums to recede over time
- Self-generated trauma, such as digging nails or pencils into chewing gum. This type of recession is more often associated with children and people with psychiatric disorders.
- Scurvy (dietary vitamin C deficiency)
- Acute necrotizing ulcerative gingivitis
- An abnormal tooth position, like a tooth wrinkled, provides an inadequate cover of one tooth or more by the jawbone.
- Piercing on the lips or tongue that fills the chewing gum by rubbing it.
- Deliberate gingival retraction. For example, adult teeth may not grow from chewing gum, and to correct this, a procedure called exposure is done. This involves gum tissue that is cut open to allow the adult teeth to grow. This is a less common cause of gum recession.
Symptoms
Gum recession is generally not an acute condition. In many cases, gums subsidence is a progressive condition that occurs gradually over the years. This is one of the reasons that it is common over the age of 40. Because changes in gum conditions from one day to another are minimal, the patient is accustomed to the appearance of the gums and is less likely to see the recession visually. Receding gums may remain unconscious until conditions begin to cause symptoms.
The following signs and symptoms may indicate a gum recession:
- Dental mobility
- Dentine hypersensitivity (too sensitive teeth) - short, sharp pain triggered by hot, cold, sweet, sour, or spicy foods and drinks. If the cementum covering the roots is no longer protected by the gums, it is easy to exfoliate exposing the dentine tubules to external stimuli.
- Teeth can also appear longer than normal (larger portion of the crown seen if gums recede)
- The root of the tooth is visible and visible
- Teeth feel grooved in the gum line
- Tooth discoloration (due to the color difference between enamel and cementum)
- The space between the teeth appears to grow (the space is the same, but it looks bigger because the gums do not fill it anymore)
- Cavity below the gum line
If gum recession is caused by gingivitis, the following symptoms may also be present:
- Puffy, red, or swollen (inflamed) gums
- Gum bleeding during brushing or flossing
- Bad breath (halitosis)
In some cases, it is a gingivitis treatment that reveals the problem of gum recession, which was previously covered by swollen gums.
Gingival grafting
Depending on the shape of gum recession and the level of bone around the tooth, the area of ​​gum recession can be regenerated with new gum tissue using various "periodontal plastic surgery" procedures of gum transplants performed by specialists in periodontics (periodontal experts). This procedure is usually solved by local anesthesia with or without conscious sedation, as the patient wishes. This may involve repositioning adjacent gum tissue to cover a recession (called a pedicle graft) or use of free graft from the gingival tissue or binding of the roof of the mouth (called free gingival graft) or subepithelial connective tissue graft.For example, so-called acellular dermal matrices (processed human skin allograft) can be used instead of tissue from the patient's own ceiling.
Technique of growth factor
Recent advances have seen the introduction of platelet derived growth factors (PDGF) injecting bone graft materials. This material is usually combined with a cellular matrix to form a soft bone paste which is then covered by an allograft. Development of the matrix of bone tissue and tissue (also known as ortho filler) results in greater osseointegration with healthy bone and soft tissue of the patient.
The healing of the procedure takes 2-4 weeks. After several months the results can be evaluated and in some cases new networks need to be reshaped in very small procedures to get optimal results. In cases where recession is not accompanied by periodontal bone loss, complete or complete coverage of the recession area can be achieved.
References
External links
- Academic presentation of gingival recession
- An extremely informative overview article from the NYTimes.
Source of the article : Wikipedia
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