These are situations where the roots are exposed, most often seen in the front tooth areas. If the gingival edge is below the cemento-enamel border, gingival recession is mentioned.
1985. In 1998, Miller made an expanded classification of marginal tissue recession and introduced a classification that included the height of alveolar bone and soft tissue between the teeth in addition to gingival recession. According to this classification, the amount of recession of the gingiva on the root surface towards the root tip is as important as the level of bone and gum in the interface region on both sides of the recession area.
Miller class 1: The recession does not extend to the mucogingival border.
Miler class 2: Recession is up to or exceeding the mucogingival border.
Miller class 3: Although there is gingival recession past the mucogingival border and bone loss at the interface, the bone loss is not intense.
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, and in Miller class 4 defects. If this is the case, coverage cannot be achieved.
Reasons for local recession in the gums:
1- The laces we call frenum have a high congenital connection and pull the gum away from the tooth with every lip movement
2- Tooth. hard brush
3- Incorrect tooth brushing method
4- Too little adhesive gingival band
5- Tissue quality with thin gingival biotype
6- Carrying out care at more frequent intervals than necessary and with wrong methods.
TREATMENT. First, oral prophylaxis is performed, removing the bacterial biofilm and hard attachments, if any, by sweeping at a 45-degree angle from the gums to the tooth edges, known as the modified Stilman method. The work begins. Covering the root surfaces is done surgically under local anesthesia. A successful treatment is determined by 1- No movement in the teeth, which we call mobility, 2- No decay in the tooth roots, 3- Presence of bone and gum in the interdental area below, 4- Whether or not the recession reaches beyond the gingival-mucosa junction.
TREATMENT METHOD. MLERI.
It varies depending on the case. If there is a recession in a single tooth, a lateral shifting flap or a double papillary shifting flap is used, as well as a free gingival graft, and if there is a recession in several teeth, a Coronal shifting flap is used. The wound is fixed with very thin stitches and covered with a paste called periodontal paste for about a week. I wish you healthy days, with best regards.
Expert Dr. GÜNGÖR KARAGÖZLÜ Gum Diseases and Surgery Specialist
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