Gingival Recession:Cause,Classification & Treatment

[Drsumitra]

 Gingival Recession Treatment

Traditionally, gingival recession has been treated with laser therapy, autogenous tissue grafting, flap designs, orthodontics, and guided tissue restoration.10 These types of treatments are not only costly and time consuming, but also may require long, painful recovery for patients.¹⁰ 

Laser treatment has been considered by some as the optimal option for correcting and halting gingival recession.¹¹ When gingival recession is observed in a patient with sensitivity caused by an exposed root, lasers have been used to remove the smear layer from the root surface to expose collagen fibers, which is believed to contribute to improved healing.12 Clinical studies, however, have been unable to find any significant improvements in recession and sensitivity from this type of treatment.¹² 

Tissue grafting is also considered one of the few viable treatment options to correct gingival recession.¹³ With the advent of tissue grafting techniques, periodontists have been able to correct gingival recession by grafting a patient’s own oral and mucosal tissues.¹⁴ This type of procedure, however, requires surgery and can be very costly. Whether using an envelope or tunnel technique, the tissue is grafted around the area of gingival recession.^15,16 It is then sutured into place and allowed to heal.¹⁷ A protective mouthpiece is often required to allow the graft site to heal properly.17 Grafting does allow for significant increases in gingival and root coverage and has proven to be very effective as a treatment option.

Another technique for correcting gingival recession is a minimally invasive flap design procedure intended for periodontally involved restorations.¹⁸ It involves cutting the tissue on 3 sides, leaving the base attached, to open the gingival tissue to allow for cleaning of the roots.¹⁸ This procedure often works with guided-tissue regeneration to allow coverage of the root and reduce gingival recession.18 Although this treatment option demonstrates good results, it still involves a surgical procedure and recovery time for the patient.¹⁸

Orthodontics may also be used to correct gingival recession, as conditions such as cross-bites and occlusion are seen as causes.¹⁹ By using orthodontic appliances to correct the abnormalities in bite and occlusion, studies have shown that gingival recession can be stopped and, many times, reversed.¹⁹ These results, however, are typically created through multidisciplinary approaches and not merely with orthodontic treatment and appliances.19 New techniques and materials, which show promising results for root coverage, have proven effective at covering, and in some cases stopping, gingival recession.