Recession and Furcations

what is the difference berween gingival shrinkgaer and true recession

shrinkage happens cos of perio or side effect of tx and id pappilae move back

recession is inflammation free and id papillae are at normal level

u dont lose teeth from recession

what is dehiscence

lack of bone

tooth is normally procline through a thin sheet of bone

associated with recession as the ginivae is pulled down to the level of the bone

what is fenestration

window in bone

usually buccal aspect

related to recession as the gingivae shinks to where the bone is gone

what are causes of true recession

morphology and anatomy of tooth and bone

chronic minor trauma ie improper tb technique

accidental injury

mild chronic inflammation esp in anteriors

frenum pulls

ortho

excessive perio scaling

parafunction - teeth not functioning properly

what is a stillmans cleft

localised recession that is a v shape

what is a mcalls festoon

refers to the gingivae that rolls back

can have the same time as a stillmans cleft or without

what issues r with recessiom

dentine hypersensitivity

root caries

tb abrasion - if root recessed then if tb abrasdion happens it will erode away quickly

where does localised recession occur

anywhere but usually lower ants

caused by fraenul pull and thin buccal bone

how do we monitor recession

LOA and pocket depths on perio chart

clinical photos

study models

how do we treat recession

eliminate causal factors

ie modify tb technique

eliminate areas of mild inflam eg replace faulty margins of restoration or remove calc

frenectomy

monitor

treat any associated issues eg

dentine hypersensitivity

prevent caries on roots - ensur good oh anf flouride

perio surgery - soft tissue grafts

what is furcation involvement

horizontal loss of support in areas where multirooted teeth converge

diagnosed via both radiograph and clinical exam

ie xray may have arrowhead lesion but cant see soft tissue

if not seen in mouth = not furcation

what is pre/molar tooth morphology

max -

1st premolar 2 roots

2nd premolar 1 root

molars 3 someyimes 2

mand -

1 and 2nd premolar 1 root

molar 2 roots

what is hamp et al

record tooth site and severty

1 - 1/3rd width

3 - full way through

why are furcations bad

reduces prognosis of a tooth ;

difficult to clean so hard to control disease

loss of vitality may happen due to accessory channels running from pulp chmaber to furcation nd bacteria can get in

how do we manage and treat furcation

manage -

grade every checkup and review/kuo

vitality test every year

treat - perio surgery

how do we treat diff grades of furcation

OHI for all

1 - pmpr furcatonplasty

2 - furcationplasty

guided tissue regern

root resection

extraction

3 - tunnel prep

root resection

extraction