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Gingival Recession

Apical migration of gingival margin from cemento-enamel junction exposing root surface caused by mechanical trauma, periodontal disease, anatomical factors, or orthodontic forces leading to tooth sensitivity, root caries, and aesthetic concerns classified by Miller and Cairo systems.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ağız ve Diş Sağlığı department. Book Appointment →

What is Gingival Recession?

Gingival recession is the apical migration of marginal gingiva from the cemento-enamel junction (CEJ) resulting in exposure of root surface. It can be localized to single tooth or generalized affecting multiple teeth.

Miller classification (1985): Class I (recession not extending beyond mucogingival junction with no interdental bone loss, predictable 100% root coverage), Class II (extending beyond MGJ without interdental bone loss, 100% coverage possible), Class III (extending beyond MGJ with interdental bone loss, partial coverage), Class IV (extending beyond MGJ with severe bone loss, no coverage possible).

Cairo classification (2011) based on interproximal CAL: RT1 (no interproximal attachment loss), RT2 (interproximal attachment loss less than buccal), RT3 (interproximal attachment loss greater than buccal). Etiologic factors: traumatic toothbrushing (most common), thin gingival biotype, periodontal disease, orthodontic movement, frenum attachment, malocclusion, smoking.

Symptoms

Visible exposure of tooth root
Tooth appearing longer than adjacent teeth
Sensitivity to hot, cold, sweet, or acidic foods
Aesthetic concerns about tooth appearance
Root caries development
Notch or groove at gingival margin
Bleeding on brushing in recession area
Persistent food impaction in recessed areas

Risk Factors

Aggressive horizontal toothbrushing technique
Hard-bristled toothbrush
Thin gingival biotype
Periodontal disease (chronic periodontitis)
Malposed teeth (buccal positioning)
Frenum or muscle attachment pull
Orthodontic treatment with excessive labial forces
Smoking and chronic mechanical irritation
Bruxism and traumatic occlusion

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Visible gum recession with root exposure
  • Tooth sensitivity affecting eating or drinking
  • Aesthetic concerns about smile appearance
  • Recession progressing despite improved oral hygiene
  • Deep recession with mucogingival deformity
  • Pre-orthodontic evaluation
  • Recession associated with periodontal disease
  • Multiple sites with progressive recession

Treatment Methods

01
Etiologic identification: brushing technique evaluation, periodontal screening, occlusal analysis
02
Non-surgical: oral hygiene modification (modified Bass technique, soft-bristled brush), desensitizing agents (potassium nitrate, fluoride varnish)
03
Composite restoration of cervical area for sensitivity and aesthetics in non-surgical candidates
04
Subepithelial connective tissue graft (CTG): palatal donor site, gold standard for root coverage (mean coverage 80-95%)
05
Coronally advanced flap (CAF): displacement of gingival tissue coronally, indicated for adequate keratinized tissue
06
Free gingival graft (FGG): for inadequate keratinized tissue, palatal donor site, less aesthetic outcome
07
Acellular dermal matrix (Alloderm) as graft alternative avoiding palatal donor site
08
Enamel matrix derivative (Emdogain) and recombinant growth factors as biologic adjuncts
09
Frenectomy for high frenum attachment causing recession
10
Orthodontic correction of malposed teeth before mucogingival surgery
11
Long-term maintenance: continued oral hygiene optimization, periodic professional care, monitoring stability

Which Department to Visit?

You can visit our Ağız ve Diş Sağlığı department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ağız ve Diş Sağlığı Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.