Gingival recession results from displacement of the gingival margin below the

cemento-enamel junction leading to exposure of the root surface of a tooth.

Although in many patients recession will go noticed and cause no symptoms, a
proportion of patients will have problems associated with recession defects. This is
particularly the case with isolated and deep defects anteriorly but can also be
associated with generalised recession.
Mechanism of recession formation
Regardless of the predisposing factors, the mechanism of formation of an isolated recession defect is
believed to be through the fusion of inflamed epithelial down growths, termed rete ridges, that result
in a cleft in the gingival margin. Recession is unlikely to occur without pre-existing gingival
inflammation; hence the importance oral hygiene instruction has in the management, as outlined later
in this article. In addition, high frenulum attachments in areas with a lack of attached mucosa may
aggravate the situation.
Overall management strategies
As stated in the previous section gingival recession is unlikely to occur in the absence of gingival
inflammation. Therefore the initial preventative strategy, once an early recession defect has been
identified, is to provide specific oral hygiene instruction. This should include advice on a less
aggressive tooth brushing technique using a gentle coronal roll technique with a small headed soft
toothbrush. Where there is a degree of crowding a single tufted brush used gently can be particularly
useful.
Where dentine hypersensitivity is a major symptom then this should be treated using well known
strategies that are beyond the scope of this article. Briefly the conservative options include the use of
a variety of toothpaste preparations, sealing of the dentinal tubules and advice regarding the
avoidance of acidic foods and drink. Generalised recession with loss of interproximal tissue can be
improved cosmetically through the provision of a silicone or acrylic removable gingival veneer. Where
more conservative methods are considered inappropriate or ineffective for localised recession defects,
then surgical management may have a role.
Sumber :

CLINICAL; Free gingival grafts to manage recession when and how?; Matthew B M
Thomas; Volume 53 No 1 of 6 January 2014; 37-41