Non-carious cervical lesions (NCCLs) with gingival recession require specific consideration on both aspects of hard and soft tissue lesion. In the restorative aspect, careful finishing and polishing of the restorations prior to mucogingival surgery is the critical factor contributing to success. Regarding surgery, assessment of the configuration of the lesion and the choice of surgical technique are important factors. The precise diagnosis and the choice of the proper treatment procedure should be made on the basis of both restorative and surgical considerations to ensure the successful treatment of NCCLs.
Diagnosis ; Gingival Recession*

PURPOSE: This study examined the factors that can be associated with the appearance of the interproximal papilla. METHODS: One hundred and forty-seven healthy interproximal papillae between the maxillary central incisors were examined. For each subject, a digital photograph and periapical radiograph of the interdental embrasure were taken using a 1-mm grid metal piece. The following parameters were recorded: the amount of recession of the interproximal papilla, contact point-bone crest distance, contact point-cemento-enamel junction (CEJ) distance, CEJ-bone crest distance, inter-radicular distance, tooth shape, embrasure space size, interproximal contact area, gingival biotype, papilla height, and papilla tip form. RESULTS: The amount of recession of the interproximal papilla was associated with the following: 1) increase in contact point-bone crest, contact point-CEJ, and CEJ-bone crest distance; 2) increase in the inter-radicular distance; 3) triangular tooth shape; 4) decrease in the interproximal contact area length; 5) increase in the embrasure space size; and 6) flat papilla tip form. On the other hand, the amount of gingival recession was not associated with the gingival biotype or papilla height. In the triangular tooth shape, the contact point-bone crest distance and inter-radicular distance were longer, the interproximal contact area length was shorter, and the embrasure space size was larger. The papilla tip form became flatter with increasing inter-radicular distance and CEJ-bone crest distance. CONCLUSIONS: The relative position of the interproximal papilla in healthy subjects was associated with the multiple factors and each factor was related to the others. A triangular tooth shape carries a higher risk of recession of the interproximal papilla because the proximal contact point is positioned more incisally and the bone crest is positioned more apically. This results in an increase in recession of the interproximal papilla and flat papilla tip form.
Gingiva ; Gingival Recession ; Incisor ; Tooth

Assessing the condition of the alveolar bone before and after orthodontic treatment is important. Recently, cone-beam computed tomography has been widely accepted as a useful tool for orthodontic treatment. Moreover, using a three-dimensional (3D) structural analysis software enables gathering detailed information and quantifying data. The aim of this study was to introduce various quantitative analyses performed before and after orthodontic treatment by using a 3D structural analysis software for evaluating the morphological condition of the alveolar bone of a patient with gingival recession around the canines.
Cone-Beam Computed Tomography ; Gingival Recession ; Humans

PURPOSE: The purpose of this study was to compare clinical effect of the Langer & Langer technique , the modified Langer & Langer technique and Bruno technique. MATERIAL AND METHODS: 30 patients who have gingiva recession(Miller class I or class II) were carried root coverage. Langer & Langer technique(14 patients/32 tooth), modified Langer & Langer technique(5 patients/10 tooth) and Bruno technique(11 patients/18 tooth) was carried. At baseline and average 3 months after operation, it was estimated clinical index(Pocket depth, gingiva recession, clinical attachment level, keratinized gingiva, scar tissue, root coverage rate) by Williams style probe. RESULT: Root coverage rate is indicated Langer & Langer technique(85%), Modified Langer & Langer technique(86%) and Bruno technique(90%). CONCLUSION: All three of the procedures were effective in gingival recession and improved clinical parameters.
Cicatrix ; Gingiva ; Gingival Recession ; Humans ; Keratins

Many factors have been implicated in the etiology of gingival recession, including faulty toothbrushing, the position of the tooth in the arch(malalignment), the presence of inflammation, frenal attachment, impingement of restoration margins, orthodontic treatment and trauma from occlusion. Among the many factors, this study was to evaluate the relationship of occlusion and gingival recession. 640 teeth without other etiologic factors of gingival recession were evaluated in 40 subjects aged 21-59 years. Only 1st, 2nd premolar and molar were included in this study. We recorded nonworking contacts, working contacts, cervical abrasion, sex, gingival recession and evaluated that relation of occlusion and gingival recession. The results of this study were as follows; 1. Teeth with nonworking contacts were significantly more gingival recession than teeth without nonworking contacts.(p<0.01) 2. Teeth with working contacts were significantly more gingival recession than teeth without working contacts.(p<0.01) 3. Teeth with cervical lesion were significantly more gingival recession than teeth without cervical lesion.(p<0.01) 4. Men's teeth were more gingival recession than women's teeth but it was not significant.(p>0.01)
Bicuspid ; Gingival Recession* ; Inflammation ; Molar ; Tooth ; Toothbrushing

Mucogingival surgery is a general term for periodontal surgeries that correct aberrant periodontal soft tissues. Conventional mucogingival surgeries with pedicle flap or autologous soft tissue graft for treatment of gingival recession and insufficient keratinized tissues are always related to disadvantages such as need for a second surgery site, limited supplies, and complaints for postoperative discomfort. In this regard, research and application of soft tissue substitutes have gained increasing attention. Various kinds of soft tissue substitutes, including acellular dermal matrix and xenogeneic collagen matrix, have been developed and applied to clinical treatment. This review aims to summarize advances in research of the characteristics and clinical effectiveness of several soft tissue substitutes and provide references for clinical application.
Gingiva ; Gingival Recession ; surgery ; Humans ; Tooth Root

ABSTRACT Using laser for treatment of dentin hypersensitivity (DH) have recently shown promising results and better immediate reduction in pain scores. However, its efficacy and mechanism of action is controversial. Thus, this study aimed to evaluate the effectiveness of diode laser compared with sodium fluoride varnish in treating DH in patients with gingival recession. Eighteen patients with Miller’s class I and class II gingival recession and hypersensitivity in at least two non-adjacent teeth were included in the study. Test surfaces (n = 25) were treated with diode laser, whilst control surfaces (n = 23) were treated with 5% sodium fluoride varnish. Visual Analogue Scale (VAS) scores were recorded for air and tactile stimulus for both groups at baseline, 15 min, 1 month and 3 months post-treatment. Results showed significant (p < 0.05) reduction in VAS scores at 15 min, 1 month and 3 months compared with baseline in both test and control surfaces, with no significant intergroup differences. However, the percentage reduction in DH was more in laser at all evaluation periods. The use of diode laser and sodium fluoride varnish showed good immediate and prolonged results. Further studies are needed to come up with more effective treatment methods.
Lasers, Semiconductor ; Dentin Sensitivity ; Gingival Recession

PURPOSE: One of the main objectives of periodontal reconstructive surgery is the coverage of exposed roots that occur due to gingival recession. and Aestheic concerns are usually the reason to perform root coverage procedure. This case report was performed to evaluate the effect of root coverage using subepithelial connective tissue graft(SCTG) on Miller's Class I marginal tissue recession. MATERIALS AND METHODS: One patient, with two Miller's class I marginal tissue recession on both maxiallay canines, was treated with root coverage using SCTG (modified Nelson's technique). At baseline, the following measurements were recorded: 1) recession depth; 2) width of keratinized giniga. At 9, 10 months post-surgery, all clinical measurements were repeated. RESULT: 1) The mean root coverage from baseline to 9, 10 months post-surgery was 92.3%. 2) The mean recession depth decreased from 6.5 mm to 0.5 mm. 3) The mean width of keratinized gingiva increased from 1.25 mm to 3.5 mm. CONCLUSION: Within the above results, root coverage using SCTG is an effective procedure to cover Miller's class I marginal tissue recession defect. Also, patient with aesthetic concern could be satisfied with this result.
Connective Tissue ; Gingiva ; Gingival Recession ; Humans ; Keratins ; Transplants

The roots of teeth exposed by gingival recession, may be successfully covered by various type of gingival grafting procedures. Vascularization of the recipient site is an essential determinant of the grafts'survival during the first healing stages. It has been suggested that a procedure by which they stimulate the periosteum presurgically will induce the proliferation of neo-endothelium in the site to be operated. The purpose of this study is to evaluate the variations in the gingival blood flow during 4weeks after periosteal stimulation in patient scheduled to receive gingival grafts and to compare variations in the gingival blood flow between smoker and non-smoker. Laser Doppler Flowmetry(floLAB(R), Moor Instruments Ltd, England ; wave length = 780mm. Max. power =1.6mW) was used to measure the gingival blood flow. 112 sites of 68 male patients (32 smokers and 36 nonsmoker), aged between 23 and 48 years (smoker : 24-44 years, mean=32.6, non-smoker : 23-48 years, mean=28.5) were monitored for the blood flow. Gingival blood flow measured at before periosteal stimulation, 1-, 2-, 3-, and 4-weeks after periosteal stimulation from 10 a.m. to 2 p.m. The difference of blood flow in each measuring time, each measuring site and between smokers and nonsmokers were statistically analyzed by MANOVA. The results were as follows : (1) Blood flow stayed increased for 2 weeks, and then, it was a tendency to decrease(p<0.05). (2) There was no statistically significant difference of blood flow change between smokers and non-smokers. (3) The blood flow at middle site had lower than mesial and distal site during the measuring periods(p<0.05). The present study suggested that blood flow change following peirosteal stimulation was significant difference, thus periosteal stimulation before gingival graft might induce favorable results in gingival recession patient.
England ; Gingival Recession ; Humans ; Male ; Periosteum ; Tooth ; Transplants

In order to evaluate the effects of the early exposure of e-PTFE membrane on the periodontal regeneration, 21 cases of 21 patients diagnosed as the chronic adult periodontitis were evaluated. All were class II furcation involvement cases. The control group was composed of 7 cases treated only by the flap operation. 14 cases were treated by the e-PTFE membrane as the experimental group, the membranes of 7 cases were exposed more than 1mm during healing period, which were named as the experimental group I, and the others, experimental group II. Clinical parameters such as probing pocket depth, clinical attachment level, bone probing depth, and gingival recession were recorded before the treatment and 6 months after the treatment. The results were as follows. 1. Significant probing depth reductions were observed for all groups(p<0.05), but no group shows significantly greater reductions than another. 2. Significant clinical attachment gains were observed for the experimental group II(p<0.05), no significant gains were observed in the other groups. 3. Significant bone probing depth reductions were observed for the experimental group II(p<0.05), no significant reductions were observed in the other groups. 4. All but the experimental group II exhibited a significant increase in gingival recession(p<0.05). The result suggested that is case of the e-PTFE membrane is exposed, the result is similar to that of flap operation without membrane. Therefore selecting the proper treatment case, intricate surgical procedure and infection control are essential for minimizing the chance of membrane exposure and finally for the good treatment results.
Chronic Periodontitis ; Gingival Recession ; Humans ; Infection Control ; Membranes* ; Regeneration