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Gingival retraction or gingival recession is when there is lateral movement of the gingival margin away from the tooth surface. [1] [2] It is usually termed gingival retraction as an intentional procedure, and in such cases it is performed by mechanical, chemical, or electrical means in order to perform certain dental surgery procedures.
In dental anatomy, the gingival sulcus is an area of potential space between a tooth and the surrounding gingival tissue and is lined by sulcular epithelium. The depth of the sulcus (Latin for groove) is bounded by two entities: apically by the gingival fibers of the connective tissue attachment and coronally by the free gingival margin.
Plaque tends to build up around the gingival margin (the gumline) and in gingival crevices or periodontal pocket (below the gumline). The release of waste products from the bacteria living in the biofilm causes an inflammatory response in the gums which become red and swollen, bleeding easily when disturbed.
The junctional epithelium, a nonkeratinized stratified squamous epithelium, [1] lies immediately apical to the sulcular epithelium, which lines the gingival sulcus from the base to the free gingival margin, where it interfaces with the epithelium of the oral cavity.
Normal gingiva may range in color from light coral pink to heavily pigmented. The soft tissues and connective fibres that cover and protect the underlying cementum, periodontal ligament and alveolar bone are known as the gingivae. The gingivae are categorized into three anatomical groups: the free, attached and the interdental gingiva.
The epithelial attachment does not migrate, it simply remains at the same attachment level found in pre-pathological health. The only anatomical landmark experiencing migration is the gingival margin in a coronal direction. In a gingival pocket, no destruction of the connective tissue fibers (gingival fibers) or alveolar bone occurs.
Desquamative gingivitis involves lesions of the free and attached gingiva.Unlike plaque-induced inflammation of the gums (normal marginal gingivitis), desquamative gingivitis extends beyond the marginal gingiva, involving the full width of the gingiva and sometimes the alveolar mucosa. [3]
No disease (gingival pockets < 3 mm) 1: Bleeding on probing, but gingival pockets < 3 mm 2: Periodontal pocketing < 3mm, but calculus (dental) present with or without plaque retentive factors such as "overhanging" restorations 3: Shallow periodontal pockets 4 - 5.5 mm (i.e. first band on probe partially visible) 4