Mack F, Mundt T, Mojon P, Kocher T, Schwahn C, Bernhardt O. Parodontalstatus bei älteren Männern und Frauen. Dtsch Zahnärztl Z. 2005; 60:403-409
Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999; 4:1-6
Yoneyama T, Okamoto H, Lindhe J, Socransky SS, Haffajee AD. Probing depth, attachment loss and gingival recession. Findings from a clinical examination in Ushiku, Japan. J Clin Periodontol. 1988; 15:581-591
Toffenetti F, Vanini L, Tammaro S. Gingival recessions and noncarious cervical lesions: a soft and hard tissue challenge. J Esthet Dent. 1998; 10:208-220
Hand JS, Hunt RH, Reinhardt JW. The prevalence and treatment implications of cervical abrasion in the elderly. Gerodontics. 1986; 5:167-170
Lührs AK, Geurtsen W, Guhr S, Günay H. Gingiva-shaded compomers: clinical results after 24 months. Clin Oral Invest. 2009; 13:95-96
Zalkind M, Hochman N. Alternative method of conservative esthetic treatment for gingival recession. J Prosthet Dent. 1997; 77:561-563
Capa N. An alternative treatment approach to gingival recession: gingiva-colored partial porcelain veneers: a clinical report. J Prosthet Dent. 2007; 98:82-84
Greene PR. The flexible gingival mask: an aesthetic solution in periodontal practice. Br Dent J. 1998; 184:536-540
Miller PD. A classification of marginal tissue regeneration. Int J Periodontics Restor Dent. 1985; 5:9-13
Lührs AK, Guhr S, Schilke R, Borchers L, Geurtsen W, Günay H. Shear bond strength of self-etch adhesives to enamel with additional phosphoric acid etching. Oper Dent. 2008; 33:155-162
Frankenberger R, Lohbauer U, Roggendorf MJ, Naumann M, Taschner M. Selective enamel etching reconsidered: better than etch-and-rinse and self-etch?. J Adhes Dent. 2008; 10:339-344
Güler AU, Yilmaz F, Yenisey M, Güler E, Ural C. Effect of acid etching time and a self-etching adhesive on the shear bond strength of composite resin to porcelain. J Adhes Dent. 2006; 8:21-25
Durmusoglu Ö, Caliskan Yanikoglu F Sevikal Sert Doku Kayiplarinin CompNatur ile Restorasyonu. Dentalife. 2006; 4:26-28
Serino G, Wennstrom JL, Lindhe J, Eneroth L. The prevalence and distribution of gingival recession in subjects with a high standard of oral hygiene. J Clin Periodontol. 1994; 21:57-63
Shay K. Root caries in the older patient: significance, prevention, and treatment. Dent Clin North Am. 1997; 41:763-793
Schiffner U, Micheelis W, Reich E. Erosionen und keilförmige Zahnhalsdefekte bei deutschen Erwachsenen und Senioren. Dtsch Zahnärztl Z. 2002; 57:102-107
Günay H, Fricke R, Triadan H. Approximale Wurzeldentinkaries – eine zweite Karieswelle?. Dtsch Zahnärztl Z. 1987; 42:904-908
Lussi A, Maurer R, Zaugg D, Hotz P, Schaffner M. Prävalenz und Risikofaktoren der Wurzelkaries. Schweiz Monatsschr Zahnmed. 2001; 4:423-432
Schiffner U. Krankheits-und Versorgungsprävalenzen bei Erwachsenen (35–44 Jahre): Zahnkaries. In: Micheelis W, Schiffner U (eds). Köln: Deutscher Zahnärzte Verlag; 2006
Schiffner U. Krankheits-und Versorgungsprävalenzen bei Senioren (65–74 Jahre): Zahnkaries. In: Micheelis W, Schiffner U (eds). Köln: Deutscher Zahnärzte Verlag; 2006
Hahn P, Reinhardt D, Schaller HG, Hellwig E. Root lesions in a group of 50–60 year-old Germans related to clinical and social factors. Clin Oral Invest. 1999; 3:168-174
Kwong SM, Cheung GS, Kei LH Micro-tensile bond strengths to sclerotic dentin using a self-etching and a total-etching technique. Dent Mater. 2002; 18:359-369
Brackett WW, Brackett MG, Dib A, Franco G, Estudillo H. Eighteen-month clinical performance of a self-etching primer in unprepared class V resin restorations. Oper Dent. 2005; 30:424-429
Wiegand A, Schmid M, Schmidlin PR. Ästhetische Kronenrandkorrektur mit Komposit. Ein Fallbericht. Schweiz Monatsschr Zahnmed. 2008; 118:427-435
Kumbuloglu O, User A, Toksavul S, Vallittu PK. Intra-oral adhesive systems for ceramic repairs: a comparison. Acta Odontol Scand. 2003; 6:268-272
Frankenberger R, Krämer N, Sindel J. Repair strength of etched vs silica-coated metal-ceramic and all-ceramic restorations. Oper Dent. 2000; 25:209-215
Panah FG, Rezai SM, Ahmadian L. The influence of ceramic surface treatments on the micro-shear bond strength of composite resin to IPS Empress 2. J Prosthodont. 2008; 17:409-414
Conservative treatment of periodontal recessions with class v-defects using gingiva-shaded composite – a systematic treatment concept Hüsamettin Günay Werner Geurtsen Anne-Katrin Lührs Dental Update 2024 38:2, 707-709.
Authors
HüsamettinGünay
Professor (Dr med dent habil), Vice-Chairman, Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Carl-Neuberg-Straße 1, D-30625 Hannover Germany
Professor (Dr med dent habil), Chairman and Head of Department, Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Carl-Neuberg-Straße 1, D-30625 Hannover Germany, Affiliate Professor of Restorative Dentistry, University of Washington, Seattle, USA
Dr med dent, Senior Lecturer, Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Carl-Neuberg-Straße 1, D-30625 Hannover, Germany
Periodontal recessions can cause aesthetic and functional problems, especially in the anterior region or when combined with exposed crown margins. A combination of periodontal disease, recession with exposed root surface, hard-tissue defects and age emphasizes the need for treating these defects. If crown margins are exposed and surgical treatment is not possible, aesthetics and function can only be improved by replacement of the restoration. The restorative treatment option with a gingiva-shaded composite is especially valuable for dental fear patients or older patients with general or local risk factors, surgical contra-indications or Class III and IV recessions with questionable prognosis of surgery.
The step-by-step-approach described in this article is an alternative, minimal-invasive treatment concept for cervical lesions in combination with all kinds of periodontal recessions, that is especially suitable for wedge-shaped defects next to exposed crown margins.
Clinical Relevance: With this treatment concept, the reader should be able to use gingiva-shaded composite for different indications, such as exposed root surfaces or crown margins in combination with recessions.
Article
Periodontal recession often poses an aesthetic problem for patients. There are many causes for the formation of periodontal recession. It may appear without inflammation or formation of periodontal pockets, or can be understood either as symptoms or outcomes of untreated or treated periodontal diseases. The prevalence of periodontal diseases is high in ’senior’ patients and was determined to be up to 85% in a group of 60–69 year olds.1
Regarding the location of gingival recession, facial/oral recession differs from proximal soft tissue lesions.2 Recession with traumatic origin is often located at the buccal area of canines and premolars. In contrast, circular recession regularly occurs in combination with general gingival inflammation.3 This leads to the conclusion of different aetiologies and pathogeneses for different types of gingival recession. As a consequence of recession, secondary damage to the exposed tooth and root surfaces often occurs. Cervical root areas are predisposed to secondary induced gingivitis or periodontitis and hypersensitivity due to difficult plaque control. The exposure of the root surface may lead to the formation of wedge-shaped defects and root caries by a combination of extrinsic, intrinsic and mechanical factors (Figure 1).4
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
