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Gingival Retraction

Gingival recession occurs when the gum recedes, exposing the root surface. Causes are multifactorial, including anatomical, physiological, and pathological factors such as brushing technique, orthodontics, and inflammation. Treatment can be non-surgical or surgical.

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
4 min read
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    This article is based on an original article in Swedish which can be found here

    See separate article: Treatment principles for gingival recession

    BACKGROUND

    Gingival recession is defined as exposed root surface caused by apical migration of the marginal gingiva [1]. The condition is very common and often has multifactorial causative factors. The prevalence varies with age and geographically. It can be up to 60% in children and adolescents and over 90% in individuals in their 50s [2].

    Etiology/Indication

    The etiology may differ depending on which part of the world one lives in. Gingival recession is commonly found in populations with good oral hygiene. It has been suggested that one type of recession may be associated with traumatic tooth brushing, primarily involving the buccal tooth surfaces, and is commonly seen in a population with good oral health. Gingival recession can also occur in populations with poor oral hygiene, where it is most related to periodontal disease and involves the proximal surfaces [2].

    There is some literature suggesting that the risk of gingival recession may be linked to the frequency of tooth brushing and the hardness of the toothbrush bristles, but the evidence is unclear [3]. An etiological factor that may be associated with gingival recession is insufficient bone in the alveolar ridge [4]. These bone defects can either be congenital (anatomical) or acquired (physiological or pathological) [5].

    Anatomical factors:

    • Buccal bone defect, fenestration
    • Abnormal tooth position, displacement of the root
    • Ectopic eruption
    • Deviations in crown/root anatomy

    Physiological factors:

    • Orthodontic movement outside the limits of the alveolar ridge, which can directly cause recession or lead to reduced gingival thickness (thin biotype)
    • Unfavorable root torque or displacement during the post-orthodontic retention phase
    • Loading factors, e.g., parafunction, interferences that can cause active tooth movements

    Pathological factors:

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