Introduction

Gum recession is the process in which the margin of the gum tissue that surrounds the teeth wears away, or pulls back, exposing more of the tooth, or the tooth's root.

Cause

There are a number of factors that can cause your gums to recession 

  1. Periodontal diseases.
  2. Aggressive tooth brushing
  3. Insufficient Dental care

Gingival recession is one of the causes of tooth hypersensitivity.

Treatment

The coronally advanced flap (CAF) is a procedure frequently used for the treatment of gum recession. The main objective of this surgical technique is to mobilize the gingival margin and reposition it at a level more coronal (incisal direction) than its original location.

Procedure 

In this case, Miller's class 1 recession is treated with coronally advanced flap procedure (fig. 1)

FIg.1 Miller's Class 1 recession in #23

Under local anesthesia, two horizontal incisions and two vertical incisions are placed around tooth as shown in figure 2.

Fig. 2  Incision design for coronally advanced flap
FIg. 3 Incision placed

After placing incisions, flap is raised coronally (fig 4) and sutured(fig 5). Ideally, 5-0 or 6-0 resorbable suture can be used for a better result. In this case, 4-0 Mersilk sutures were used.

Fig. 4  Flap is coronally placed
Fig. 5 4-0 mersilk suture are placed.

Fig 6 shows complete root coverage of tooth after 3 months. Proper oral hygiene and regular dental visits can maintain this result for longer period of time.

Fig. 6 After 3 month Follow up

Conclusion

Gum recession is a common gum problem and one of the causes of tooth hypersensitivity. 

Minor gum recession like Miller's class I can be successfully treated minor surgical procedure like a coronally advanced flap. Advanced gum recession like class II and Class III required a more advanced regenerative procedure.