gingival recession - non-inflammatory nature of this disease, which is characterized by a decrease in height and amount of gum in the neck of the tooth, exposing the root.The neck of the tooth - a place of transition in the crown of the tooth root, its most narrow part.Normally limited to the boundary below the neck gum, which tooth is not covered, but only touches it.Currently, the population has increased the number of patients complain of tooth hypersensitivity and roots.A common reason for this is gum recession, which affects the appearance of the teeth, gums aesthetics of a smile.Desna looks cropped, especially if multiple lesions.Often at the same time it exposes the root dentin (the tooth roots are not covered by enamel).Dentin has a light yellow color, in some people it is a bit darker.This causes some discomfort in patients, especially in females.Since dentin remains open, non-compliance with hygiene may prompt the development of caries.Dentinal tubules, which ar
prevalence of gingival recession progresses with age.In young people, the incidence is 7-10%, in a period of 45-70 years is 85%, and in the elderly reaches 99%.Due to the relative increase in the proportion of older people in society, the frequency of references in the future will increase.There large gum recession in men compared to women.
There are localized and generalized gingival recession.Localized gingival recession - is uncovered neck and root of the tooth.Generalized gum recession - is baring necks and root surfaces of teeth from a group of both the top and bottom jaw.The variant of the recession on both jaws.
Due to the destructive changes in bone, soft tissues quantitative disadvantage, treated patients must come to a dentist check-ups every 6 months.The method will provide more diagnostic X-ray examination, the results of which are more informative.The doctor will be able to accurately assess the condition of the bone tissue and to prevent re-surgery.The objective of dental surgeons is to achieve the best long-term results of treatment of patients parodotologicheskih.Their goal is the combination of causal treatment and surgery.Depending on the status and scope of the gums, gingival papillae structure, the depth of the vestibule of the oral cavity is defined treatment of gingival recession.
reasons gingival recession
Causes of gingival recession are very diverse: from congenital anatomical features, injuries to the age-related changes and inflammatory periodontal disease.Each person has an individual structure of the alveolar.Sometimes the teeth with powerful and long roots have a thin layer of cortical bone, so that the blood supply to this area is carried out not in full, which causes the formation of a defect.The anomalies of the teeth, bite pathology also leads to the development of gingival recession.Small vestibule of the oral cavity (5 mm.) Change the ratio between the edge and the attached gingiva, breaking trophism of mucous membrane.With regard to injury gums, they can be acute or chronic.For permanent injuries include bad habits (nail biting and handles), the application of rigid toothbrush, rough brushing teeth, sharp edges of fillings, dentures inappropriate clinical requirements, injuries in sporting activities.
Plaque plays an important role in the development of gingival recession.Conglomerate microorganisms and food residues leads to gingivitis and gingival margin offset.Dental plaque provoke the development of periodontal disease, which causes the disease.In orthodontic treatment may increase the strength of tooth movement that may lead to a thinning of the gums.Poor oral hygiene in the treatment of a bracket system is a complementary factor of this disease.Iatrogenic pathology - a concept associated with such careless actions of a doctor, as a leak of arsenious paste on the gums, which further causes necrosis of soft tissue, mucous membranes and bone alveolar with the further development of the recession.
may experience a recession after mechanical injury gums burs in the formation of cavities, filling in the finishing (grinding, polishing) dentist, leaving jagged edges of crowns and fillings.
a result of inadequate endodontic treatment have these consequences root fracture and perforation.Further, this can cause the formation of chronic destructive processes in the apical tissues.Bone resorption is accelerated by perforating the front surface of the root, the root of the recession going on and there is a fistula.Gingival recession can be the first symptom in vestibular root perforation.
Symptoms and signs of gingival recession
In the initial period of gum recession is different pronounced symptoms.Marked reduction in the gums when patients notice a significant recession.Painful sensations arise at the stage of the exposed roots of the tooth.Changing the temperature (absorption of cold air), the eating of sweet, sour, salty, and chewing rough and rigid food causing an unpleasant sensation.On receiving dental doctor can detect root caries.If the defect is located on the front teeth, the patients will complain of a lack of aesthetics, which is rendered with a smile.
The diversity of gingival recession entails a variety of symptoms.
Traumatic gum recession occurs more often in young age, frequent location - the upper incisors, canines, and premolars.Its size is 3 mm.Perhaps valikoobraznoe thickening of the gums, inflammation of the missing, plaque in moderation, sensitivity increased.
Symptomatic gum recession caused by inflammatory periodontal diseases, is made up of dental plaque, bleeding gums, loose teeth, the presence of periodontal pockets, multiple gingival recession on different surfaces of the teeth.
physiological gingival recession associated with the age of the patient.Usually these are people older than 60 years.The recession in this case is observed in both jaws, it is expressed, there is no inflammation, the teeth are stable, immobile.
Treatment of gingival recession
Treatment of gingival recession in the first place should be comprehensive, that is, eliminate the etiological, pathological and symptomatic causes.These include: the elimination of bad habits, therapeutic dental health, correction of malocclusion, kappa teeth protection in sports, maintaining oral hygiene in satisfactory condition (professional oral hygiene doctor hygienist every six months).Elimination of gingival recession can be carried out at the stages of prevention at the examination by a dentist.If time does not make the correct treatment, the recession could lead to serious consequences: the development of inflammation in the tissues of the gums and loose teeth, up to their complete loss.
Patients are wondering what you can achieve the same methods to eliminate this lack of aesthetic and physiological like gum recession?Before planning further treatment is necessary to inform the patient about the need for X-ray examinations of the teeth-jaw system.In particular may offer orgotantomogrammu or computed tomography.Apparatus for CT have not all dental offices and clinics.This method is expensive and not all patients will agree to pass the budget of Computer Science.An alternative and less costly research is orthopantomogram.This method is also informative, the doctor will be able to fully create a treatment plan to the patient to make a financial plan.The result of this study is the patient on his hands and he will need specialists of other profiles, by any chance the patient wants to continue to have dentures dentist-orthopedist.
current treatments are many.Doctors offered medical therapy and surgery.Surgical treatment is aimed at the resumption of the gingival margin and the overlapping of the exposed roots.Removal of gingival recession depends on the age of the patient, as well as the causes and characteristics of a pathology.
operations during gum recession: the use of the lateral flap, move the gingival flap, transplantation of tissue flap to the hard palate, guided tissue regeneration.Closing gingival recession is conducted after 7-10 days after the implementation of a mandatory professional oral hygiene.Closing gingival recession with lateral flaps (also called "flap on the leg") is used in a single recession with enough gum tissue.At the beginning of the operation carried out infiltration anesthesia, make two parallel cuts, separates submucosal layer is formed by a flap.Held mechanical and pharmacological treatment of the root surface, and then the flap is fixed with catgut sutures.Plastic gingival recession this method gives very good results, matching the color of fabric reaches the optimum aesthetic.
Moving trapezoidal gingival flap to the defect region has a number of limitations - the amount of the gum to be big.Gingival recession can be eliminated at both generalized and localized form.Treatment results are good enough.
transplantation of tissue flap put into practice dentist for a long time.Gingival graft is created from the mucous membrane of the hard palate.The flap is moved to the place of the bare root, fixed, thus eliminating the defect.The disadvantages of this technique are discomfort in the wound surface of the hard palate and color discrepancy regenerate gum tissue.
modern way plastic when gingival recession is the method of guided tissue regeneration, created activation of cell proliferation tissue using resorbable and nerezorbiruemyh separation membranes.Directed recovery allows you to restore the damaged structure of periodontal.Using nerezorbiruemyh membranes require additional surgery to remove it.Nerezorbiruemye membranes have a rigid frame and do not adapt to the underlying tissues as resorbable.Hardness membranes may facilitate its opening, which leads to contamination by microorganisms with the possible exclusion.Application of absorbable membrane eliminates the need for a second operation to remove them.Efficacy resorbable membranes nerezorbiruemymi compared with approximately 8% lower.Operations at the gingival recession on statistics give good results: 83% of patients are satisfied with the treatment.
Drug treatment shows good results, reaching the absolute regeneration of periodontal structures.Protein components of the enamel matrix occur in tissues before and are present during the entire maturation period cement.
protein-based material is such as amelogenin, which participates in the formation and maturation of the enamel of the tooth root.Mesenchymal cells of tooth germ affect enamel base, forming on the surface of the enamel acellular cement.
If patients are focused on the cost of treatment, have contraindications to surgery, there is an allergy to the drug, another possible way to eliminate gingival recession.Naked root of the tooth is covered with a seal made of composite material, in the chosen color of the gum tissue.This method is not efficient and is not a long-term, but it is the place to be.The positive side of this method is the elimination of aesthetic defect.