Managing the consequences of periodontal diseases/treatment: gingival recession

Gingival recession (GR), a form of mucogingival deformity, has a number of definitions. The American Academy of Periodontology describes it as ‘the location of the marginal tissue apical to the cemento-enamel junction’,¹ while others regard it is an apical shift of the gingival margin over the cemento-enamel junction and exposure of the root surface to the oral environment.² Amongst the many terms, the most commonly referred to is ‘the migration of the gingival margin apical to the cementoenamel junction’.³ Irrespective of which definition is referred to, however, it has been shown that some degree of GR is present in most adults regardless of their standard of oral hygiene and, with age, this appears to increase.²

Gingival recession has a complex and multifactorial aetiology. If left to progress, its sequelae can include dentine hypersensitivity, tooth abrasion, carious root lesions and patient-related aesthetic concerns. Periodontal phenotype, presence of periodontitis and its treatment, traumatic elements, tooth position, muscle attachments and iatrogenic factors have each been shown to have an influence on the presence and extent of GR. Other characteristics considered to be important in the development of recession defects include keratinized tissue width, gingival thickness, bone morphotype and support.