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Gum Recession
By
Abd Alsalam Jawad
Rusul Mohammed
Supervised by
Fifth grade Dr. Bushra Hamza Aljibory

Introduction
 Gingival recession is the apical migration of gingival
margin to the cementoenamel junction (CEJ). The
distance between the CEJ and gingival margin gives the
level of recession. Gingival recession can be caused by
periodontal disease, accumulations, inflammation,
improper flossing, aggressive tooth brushing, incorrect
occlusal relationships, and dominant roots. These can
appear as localized or generalized gingival recession.
 Gum recession is a problem affecting almost all middle
and older aged to some degree.

Prevalence of Gum recession
 According to the US National Survey, 88% of seniors
(age65 and over) and 50% of adults (18 to 64)
present recession in one or more sites; progressive
increase in frequency and extent of recession is
observed with increase in age .
 In the youngest age cohort (30 to 39 years), the
prevalence of recession was 37.8% and the extent
averaged 8.6%teeth. In contrast, the oldest cohort,
aged 80 to 90 years, had prevalence of 90.4% (more
than twice as high) and the extent averaged 56.3%
teeth (more than six times as large).
 Gingival recession is associated with the presence
of supragingival and subgingival calculus and
showed that the lingual surfaces of the lower
anterior teeth were most frequently affected in 20–
34 year age group in Tanzanian adult population

Etiology
 Calculus
 Tooth Brushing
 High Frenal Attachment
 Position of the Tooth
 Tooth Movement by Orthodontic Forces
 Improperly Designed Partial Dentures
 Smoking
 Restorations
 Chemicals

5. Tooth Movement by Orthodontic
Forces

6. Improperly Designed Partial
Dentures

Predisposing factors Precipitating factors
Tooth (mal)position/tipping *Plaque, plaque-induced inflammation:
Gingivitis, periodontitis
Gingival
Gingival biotype Thin tissue Functionally
inadequate quantity/quality of keratinized/attached
gingiva
*Calculus
Frenum pull/muscle attachment/muscular
dysbalanced/shallow vestibules
*Trauma: mechanical, chemical, thermal Smoking
Overzealous toothbrushing/ ossing Piercings Habits
Deep bite
Bone dehiscence Iatrogenic:
Orthodontic tooth movement
Subgingival restoration margins
Oral surgery
Ill-fitting restorations/prostheses

Tooth (mal)position/tipping Gingival biotype
Frenum pull Bone dehiscence

Effect of Gum recession
 Aesthetics
 Gingival Bleeding and Plaque Retention
 Hypersensitivity
 Caries

Treatment
 Restorations
 Construction of Gingival Mask
 Root Conditioning
 Frenectomy
 Surgical Root Coverage Techniques

2. Construction of Gingival Mask

5. Surgical Root Coverage
Technique

Case 1
 A 43-year-old female
patient complained of
hypersensitivity in spite
of using anti-
hypersensitivity paste
since 2 months and was
also concerned about
the esthetics. Patient
had gingival recession on
the maxillary left canine
and first premolar at the
first examination

Case 2
 A 31-year-old
female patient
complained of a
black triangle in
the upper front
teeth region
since 6 months
and was
concerned
about the
esthetics and
whistling sound
while speaking

Discussion
 The main goal of periodontal therapy is to improve
periodontal health and thereby to maintain a patient’s
functional dentition right through his/her life. However,
aesthetics symbolizes an inseparable part of today’s oral
therapy, and numerous procedures have been proposed to
preserve or enhance patient aesthetics. This treatment has
principally been justified by the patient’s wish to advance
the aesthetic appearance when there is an exposed root.
Etiology and the contributing factors are chief when deciding
on appropriate treatment procedures for patients with
localized gingival recession. In the cases presented,

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Gingival Recession

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