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Gingival Retraction – Treatment Principles

Treatment of gingival recession may involve both non-surgical and surgical methods. Initial treatment focuses on eliminating etiological factors and improving oral hygiene, while surgical procedures like periodontal plastic surgery are used in more severe cases.

Author: Tom Guan • DDS • Specialist in Periodontology • Sollentuna Specialist Clinic • Stockholm / Aqua Dental • Uppsala
Reviewed by: Aleksandar Milosavljevic • Dental Specialist • PhD • Department of Periodontology • Malmö
6 min read
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    This article is based on an original article in Swedish which can be found here

    For general information on gingival recession, see separate article: Gingival retraction

    TREATMENT

    Gingival recession can be treated with surgery, known as periodontal plastic surgery, to restore or improve the lost soft tissue [1]. Note that complete root coverage is not always the treatment goal; rather, the primary treatment objectives should be based on the patient's subjective discomfort and expectations.

    In some cases, non-surgical treatment alone may suffice. Therefore, it is essential to review which initial treatments can be performed and to evaluate the non-surgical treatment before considering periodontal plastic surgery.

    Initial Treatment

    It is important to assess whether the etiological factors can be eliminated.

    The following initial treatments may be relevant:

    • Instruction on tooth brushing technique, known as the rolling technique, to optimize plaque control
    • Hygiene treatment to address inflammation
    • Removal of retainers that have caused unfavorable root displacement
    • Grinding, relieving loading factors
    • Consultation with an orthodontist, possibly orthodontic appliances to neutralize root displacement
    • Addressing other factors, e.g., recommending cessation of snuff, removing piercings, adjusting/restoring restorations, repairing wedge-shaped defects

    Surgical Treatment

    In cases of severe gingival recession, particularly with symptoms, periodontal plastic surgery may be indicated. Periodontal plastic surgery is a highly technique-sensitive procedure and can vary in difficulty depending on the type of recession. This type of surgery requires extensive experience and is preferably performed with microsurgical instruments by specialists in periodontology.

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