LOCAL GINGAL RETRACTIONS

These are the situations where the roots are mostly seen in the anterior teeth areas. If the gingival margin is below the enamel-cementum boundary, gingival recession is mentioned.

In 1985, Miller made an expanded classification in marginal tissue recession and introduced a classification that included the height of alveolar bone and soft tissue between teeth in addition to gingival recession. According to this classification, it is as important as the amount of recession on the root surface of the gingiva towards the root tip, as well as the level of bone and gingiva in the interface area on both sides of the recession area.

Miller class 1: Withdrawal does not extend to the mucogingival border.

Miler class 2: Withdrawal up to or beyond the mucogingival border.

Miller class 3: Gingival recession past the mucogingival border and bone loss at the interface, although bone loss is not extensive.

Miller class 4: The defect has passed the mucogingival border, there is excessive positioning of the tooth, there is severe bone loss at the interface.

Although the root surface can be completely covered in Miller class 1 and 2 defects, partial coverage is provided in Miller class 3, whereas coverage cannot be achieved in Miller class 4 defects.

Causes of local recession in the gums:

1- Congenital high connection of the laces we call frenilum and pulling the gingiva and separating it from the tooth with every lip movement

2- Toothbrush is hard

3- Inaccuracy of the tooth brushing method

4- Too little conjoined gingival band

5- Tissue quality with thin gingival biotype

6- Maintenance at frequent intervals and with wrong methods when necessary.

TREATMENT. First, oral prophylaxis is performed, and it starts with the removal of bacterial biofilm and hard attachments, if any, with a 45-degree sweeping method from the gums to the tooth edges, known as the modified Stilman method. Covering the root surfaces is performed with surgical methods under local anesthesia. A successful treatment is determined by 1- No movement in the teeth, which we call mobility, 2- No caries in the tooth roots, 3- Presence of bone and gingiva in the lower interdental region, 4- Whether the recession reaches beyond the gingival-mucosa junction.

METHODS OF TREATMENT.

It depends on the case. If there is a single tooth recession, a side-shifted flap or a double papillary slide flap is used, as well as a free gingival graft, if a few teeth are recessed, a Coronal slide flap is used. The wound is fixed with very thin sutures and covered with a patch called periodontal patch for about a week. I wish you a healthy day, with my best regards.

Specialist Dr. GÜNGÖR KARAGÖZLÜ Gum Diseases and Surgery Specialist

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