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Periodontal diseases

Cosmetic surgery of the gums

Sometimes, patients with wide smiles detect that their gums are receding from one or more teeth, making their smiles less attractive. Today these problems can be solved with mucogingival surgery techniques that offer excellent results.
As always, it is necessary to make a correct diagnosis of the case, analyse the causes and then choose the correct technique for your specific case.
First, it is important to rule out the existence of underlying periodontal disease (pyorrhea), in which case it must be treated first. Once we have analysed the case and obtained the necessary conclusions, we take the decision to carry out the surgery. To do so there are different techniques that we can perform.

Causes of receding gums

Thin gums

As with the skin of our body, some people have it thinner or thicker, the same happens with the gums, genetically it can be determined that it is thinner or thicker.
People with thinner gums are at higher risk of developing a gum recession, since the thickness of the gum protects from external agents that can damage it.

Periodontal disease

Periodontal disease causes the bone that surrounds the teeth to be lost. As this bone is lost, the gum may accompany it, since the bone is the support of the gum. In cases of advanced periodontal disease, it is typical to see black spaces between the teeth, precisely due to this loss of bone and gum.
In cases of receding gums due to periodontal disease, it will not be possible to regain the original position of the gingiva.

Mechanical or brushing trauma

An incorrect brushing technique, or using a hard brus, can cause micro-trauma to the gum, which, if maintained over time, can cause the gum to retract.

Loss of bone

Any loss of bone that occurs around the teeth can cause recession of the gums, as they lose their support and their nutrients supply.

Orthodontics

Inappropriate tooth movements during orthodontic treatment can cause part of the bone surrounding the tooth to be resorbed, causing subsequent receding gums.
This type of retraction is typical in the lower incisors, due to an excess of forward movement, which causes that bone that surrounds the tooth on its anterior face to disappear, leaving the root of the tooth completely bare or with a minimum amount of gum.

What are the consequences of receding gums?

Sometimes a lack of attached gingiva can present a gingival recession. This can lead to sensitivity, health and cosmetic problems.
A tooth that has part of its root exposed can generate sensitivity especially to cold and acidic things, because the root of the tooth is not covered with enamel like the crown, offering a very important protection, but is covered with cement, which is a very thin and weak component.
In addition to being able to cause sensitivity, it is also easier for cavities to develop on this surface, accumulate more plaque and tartar, which can cause gingivitis or periodontitis.
The receding gums also entails an aesthetic problem, since the harmony and the relationship of proportions between tooth and gum are lost.

How are receding gums treated?

Gum grafts:

There are different types of techniques used to treat gum recessions.
Some of these techniques consist of making a subepithelial graft. The procedure consists of obtaining a small piece of gum from the palate that is later grafted onto the previously prepared area where the recession exists. The area will gradually heal, thus covering the injury. This new tissue will be exactly identical to adjacent areas. The healing process takes about 6 weeks, but gum reshaping can continue for up to 12 months later.
We can correct other types of recessions with a free gingival graft also obtained from the palate that we transfer to the base of the recession to create a strong gum band in that area whose function is to prevent further retraction. In a second phase we can bring that firm gum that we now have towards the crown to try to cover the recession.

Another technique to cover recessions is to use graft materials from animals or humans instead of the patient's own tissue. The graft is modeled based on the anatomy of the recession to be covered. The type of graft will heal in the same way as the patient's own connective tissue. With these techniques, we not only managed to cover the recession, but also achieve a sufficient gum thickness to prevent its reappearance and achieve correct gingival health.

Plastic microsurgery

There are multiple techniques for microsurgery that help us correct gum retractions and improve that smile.
One of them is to make a displaced flap (taking the gum next to the recession to move it to the recession area). We can also use different materials of both animal and human origin such as collagen or acellular dermal matrix.

Gummy smile and gingivectomy:

The gummy smile is a facial alteration, especially focused on the smile, which is defined by the excessive exposure of the gums when smiling.
To correct this problem, a procedure called gingivectomy is performed, which simply consists of trimming the excess gum that covers the crown of the tooth, exposing a greater amount of tooth, thus achieving an aesthetic improvement.
Another solution for gums that are too long, that is, the so-called gummy smile, can be the lengthening of the tooth's crown, which is the second most common aesthetic periodontal procedure among patients under 50 years of age, according to a survey carried out to carried out among numerous periodontists.
With crown lengthening, excess gums and bone tissue is recontoured to expose more of the natural tooth. This can be done to one tooth to match the gum line, or multiple teeth to expose a natural wide smile.

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