GINGIVAL RECESSION

Gingival recession is defined as the exposure of the root surface by an apical shift in the position of
the gingiva

TYPES
 There are two types of recession:
i. visible, which is clinically observable
ii. hidden, which is covered by gingiva and can only be measured with probe
 Gingival recession may also be localized or generalized.

ETIOLOGY OF GINGIVAL RECESSION

 Plaque-induced gingival inflammation is the primary etiological factor responsible for gingival
recession; next most common cause is faulty tooth brushing

 Other secondary/contributing factors of gingival recession are broadly categorized (for

convenience) as:
a. Anatomic factors
b. Habits
c. Iatrogenic factors
d. Physiologic factors

Anatomic factors include:

1. Tooth malposition or position of the tooth in the arch
− when a tooth is labially placed, the periodontium on the labial aspect will be invariably
thin
− when this is exposed to any kind of trauma or frictional forces, gingival recession
results
2. Presence of dehiscence and fenestrations
3. Gingival ablation from soft tissues like cheek, lips, etc.
4. Root-bone angle and mesiodistal curvature of the tooth surface. In rotated and facially-displaced
teeth, bony plates are either thinned or shortened and recession results from repeated trauma
to the thin periodontal tissues.

Habits:
5. Faulty tooth brushing or brushing with hard bristles may lead to gingival recession
6. Recently it has been noted that there may be a positive relationship between smoking and
recession. But the exact mechanism is not reported.

Iatrogenic factors:
7. Primary trauma from occlusion has been reported to cause gingival recession
8. Orthodontic movement in a labial direction and improper restorations can lead to gingival
recession.

Physiologic factors:
9. Gingival recession was thought to be a physiologic process related to aging. However, this idea
was discarded because there was no convincing evidence for a physiologic shift of the gingival
attachment.

CLINICAL SIGNIFICANCE OF GINGIVAL RECESSION

1) The exposed root surface may be extremely sensitive
2) Hyperemia of the pulp may result due to gingival recession
3) Interproximal recession creates oral hygiene problems thereby resulting in plaque accumulation
4) It is aesthetically unacceptable