Dentaltown January 2017 - 67

A

s a practicing periodontist,
I've found that recognizing, diagnosing and
understanding treatment
options for gingival recession remains a confusing
mystery to many dentists.
I hope to shed some light on how a periodontist sees this.
We'll explore what a mucogingival
(receded gums) defect is and how to identify
one, what and where to measure, and when,
why and how we can treat them.
The term mucogingival refers to the
area of the mucosa and gingival tissues, so
a mucogingival defect is one that involves
either the mucosa, gingiva or both. This short
article will center strictly around gingival
recession or areas that lack attached gingiva
and possibly keratinized gingiva.
Before diving into this too far, we must
start with the most commonly recognized
classification system: the Miller Defect
Classification.
Miller's Class 1 Defect: Recession that
does not extend to or beyond the mucogingival junction, with no loss of interdental
bone or soft tissue. Full root coverage is
possible, especially when recession hasn't
advanced past 3 millimeters.
In Fig. 1, notice that the recession
doesn't extend past the mucogingival
junction, where pink gingival tissue turns

into red mucosal tissue. There also is no
loss of the interdental papilla; we don't
see black triangles. Here, 100 percent root
coverage is possible.
Miller's Class 2 Defect: Recession
does extend to or beyond the mucogingival
junction, with no loss of interdental bone
or soft tissue. Full root coverage is possible,
especially when recession has not advanced
past 3mm.
In Fig. 2, notice that the recession extends
past the mucogingival junction, but there is
no loss of the interdental papilla. Full root
coverage is possible here.
Miller's Class 3 Defect: Recession that
may extend to or beyond the mucogingival
junction, with loss of interdental bone
and soft tissue. Teeth that are severely
malposed or outside the bony envelope
also fall in this category. Full root coverage
is unlikely.
In Fig. 3, notice that the recession
extends past the mucogingival junction,
and there is loss of the interdental papilla
on the picture on the left. 100% root
coverage is impossible. In Fig. 4, notice
that the canine is buccal malposed, so root
coverage is not 100 percent likely.
Miller's Class 4 Defect: Recession which
may extend to or beyond the mucogingival
junction, with loss of interdental bone and
soft tissue. Teeth that are severely malposed
or outside the bony envelope also fall in this

Fig. 1

Fig. 2

Fig. 3

Fig. 4

dentaltown.com \\ JANUARY 2017

67



http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown January 2017

CE Update
On Dentaltown.com
Study Abroad: Live CE Events
Industry News
New Products
Poll
Product Profile: Glidewell Laboratories
Ad Index
Product Profile: OCO Biomedical
The Curious History of Occlusion in Dentistry
Making a Good First Impression
Townie Meeting 2017 Preview
Howard Speaks: Suck It Up Buttercup
Professional Courtesy: Package Deal
Show Your Work: Crowning a Winner
Product Profile: Aspen Dental
Dentally Incorrect
Message Boards: Best Way to Text Patients
Message Boards: Teach An Old Guy About Perio
Message Boards: Powerprox 6-Month Braces (Trouble Getting Started)
Office Visit
Does My Patient Need A Gum Graft
Earn Your Keepers
CE Requirements by State
CE: Honing Our Edge
Dentaltown January 2017 - Intro
Dentaltown January 2017 - Cover1
Dentaltown January 2017 - Cover2
Dentaltown January 2017 - 1
Dentaltown January 2017 - 2
Dentaltown January 2017 - 3
Dentaltown January 2017 - 4
Dentaltown January 2017 - 5
Dentaltown January 2017 - 6
Dentaltown January 2017 - 7
Dentaltown January 2017 - 8
Dentaltown January 2017 - 9
Dentaltown January 2017 - On Dentaltown.com
Dentaltown January 2017 - 11
Dentaltown January 2017 - Howard Speaks: Suck It Up Buttercup
Dentaltown January 2017 - 13
Dentaltown January 2017 - 14
Dentaltown January 2017 - 15
Dentaltown January 2017 - Professional Courtesy: Package Deal
Dentaltown January 2017 - 17
Dentaltown January 2017 - CE Update
Dentaltown January 2017 - 19
Dentaltown January 2017 - 20
Dentaltown January 2017 - 21
Dentaltown January 2017 - Study Abroad: Live CE Events
Dentaltown January 2017 - 23
Dentaltown January 2017 - Industry News
Dentaltown January 2017 - New Products
Dentaltown January 2017 - Poll
Dentaltown January 2017 - 27
Dentaltown January 2017 - Show Your Work: Crowning a Winner
Dentaltown January 2017 - 29
Dentaltown January 2017 - 30
Dentaltown January 2017 - 31
Dentaltown January 2017 - Message Boards: Best Way to Text Patients
Dentaltown January 2017 - 33
Dentaltown January 2017 - 34
Dentaltown January 2017 - 35
Dentaltown January 2017 - 36
Dentaltown January 2017 - 37
Dentaltown January 2017 - Message Boards: Teach An Old Guy About Perio
Dentaltown January 2017 - 39
Dentaltown January 2017 - 40
Dentaltown January 2017 - 41
Dentaltown January 2017 - 42
Dentaltown January 2017 - Message Boards: Powerprox 6-Month Braces (Trouble Getting Started)
Dentaltown January 2017 - 44
Dentaltown January 2017 - 45
Dentaltown January 2017 - 46
Dentaltown January 2017 - 47
Dentaltown January 2017 - Office Visit
Dentaltown January 2017 - 49
Dentaltown January 2017 - 50
Dentaltown January 2017 - 51
Dentaltown January 2017 - 52
Dentaltown January 2017 - 53
Dentaltown January 2017 - The Curious History of Occlusion in Dentistry
Dentaltown January 2017 - 55
Dentaltown January 2017 - 56
Dentaltown January 2017 - 57
Dentaltown January 2017 - 58
Dentaltown January 2017 - 59
Dentaltown January 2017 - 60
Dentaltown January 2017 - 61
Dentaltown January 2017 - 62
Dentaltown January 2017 - Making a Good First Impression
Dentaltown January 2017 - 64
Dentaltown January 2017 - 65
Dentaltown January 2017 - Does My Patient Need A Gum Graft
Dentaltown January 2017 - 67
Dentaltown January 2017 - 68
Dentaltown January 2017 - 69
Dentaltown January 2017 - 70
Dentaltown January 2017 - 71
Dentaltown January 2017 - Earn Your Keepers
Dentaltown January 2017 - 73
Dentaltown January 2017 - 74
Dentaltown January 2017 - 75
Dentaltown January 2017 - Townie Meeting 2017 Preview
Dentaltown January 2017 - 77
Dentaltown January 2017 - 78
Dentaltown January 2017 - 79
Dentaltown January 2017 - 80
Dentaltown January 2017 - 81
Dentaltown January 2017 - 82
Dentaltown January 2017 - 83
Dentaltown January 2017 - 84
Dentaltown January 2017 - 85
Dentaltown January 2017 - 86
Dentaltown January 2017 - 87
Dentaltown January 2017 - Product Profile: Glidewell Laboratories
Dentaltown January 2017 - Ad Index
Dentaltown January 2017 - Product Profile: OCO Biomedical
Dentaltown January 2017 - 91
Dentaltown January 2017 - Product Profile: Aspen Dental
Dentaltown January 2017 - 93
Dentaltown January 2017 - CE Requirements by State
Dentaltown January 2017 - 95
Dentaltown January 2017 - CE: Honing Our Edge
Dentaltown January 2017 - 97
Dentaltown January 2017 - 98
Dentaltown January 2017 - 99
Dentaltown January 2017 - 100
Dentaltown January 2017 - 101
Dentaltown January 2017 - 102
Dentaltown January 2017 - Dentally Incorrect
Dentaltown January 2017 - 104
Dentaltown January 2017 - Cover3
Dentaltown January 2017 - Cover4
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2021
https://www.nxtbook.com/farran/dentaltown/2021January
https://www.nxtbook.com/farran/dentaltown/2020December
https://www.nxtbook.com/farran/dentaltown/2020November
https://www.nxtbook.com/farran/dentaltown/2020NewGrad
https://www.nxtbook.com/farran/dentaltown/2020October
https://www.nxtbook.com/farran/dentaltown/2020September
https://www.nxtbook.com/farran/dentaltown/2020August
https://www.nxtbook.com/farran/dentaltown/2020July
https://www.nxtbook.com/farran/dentaltown/2020June
https://www.nxtbook.com/farran/dentaltown/2020May
https://www.nxtbook.com/farran/dentaltown/2020April
https://www.nxtbook.com/farran/dentaltown/2020March
https://www.nxtbook.com/farran/dentaltown/2020February
https://www.nxtbook.com/farran/dentaltown/2020January
https://www.nxtbook.com/farran/dentaltown/2019December
https://www.nxtbook.com/farran/dentaltown/2019November
https://www.nxtbook.com/farran/dentaltownuk/2019OctoberNovember
https://www.nxtbook.com/farran/dentaltown/2019October
https://www.nxtbook.com/farran/dentaltown/2019NewGrad
https://www.nxtbook.com/farran/dentaltown/2019September
https://www.nxtbook.com/farran/dentaltown/2019August
https://www.nxtbook.com/farran/dentaltown/2019July
https://www.nxtbook.com/farran/dentaltownuk/2019JuneJuly
https://www.nxtbook.com/farran/dentaltown/2019June
https://www.nxtbook.com/farran/dentaltown/2019May
https://www.nxtbook.com/farran/dentaltownuk/2019AprilMay
https://www.nxtbook.com/farran/dentaltown/2019April
https://www.nxtbook.com/farran/dentaltown/2019March
https://www.nxtbook.com/farran/dentaltown/2019February
https://www.nxtbook.com/farran/dentaltownuk/2019FebruaryMarch
https://www.nxtbook.com/farran/dentaltown/2019January
https://www.nxtbook.com/farran/dentaltownuk/2018Winter
https://www.nxtbook.com/farran/dentaltown/2018December
https://www.nxtbook.com/farran/dentaltown/2018November
https://www.nxtbook.com/farran/dentaltownuk/2018November
https://www.nxtbook.com/farran/dentaltown/2018October
https://www.nxtbook.com/farran/dentaltownuk/2018October
https://www.nxtbook.com/farran/dentaltown/2018NewGrad
https://www.nxtbook.com/farran/dentaltown/2018September
https://www.nxtbook.com/farran/dentaltownuk/2018September
https://www.nxtbook.com/farran/dentaltown/2018August
https://www.nxtbook.com/farran/dentaltownuk/2018July
https://www.nxtbook.com/farran/dentaltown/2018July
https://www.nxtbook.com/farran/dentaltownuk/2018June
https://www.nxtbook.com/farran/dentaltown/2018June
https://www.nxtbook.com/farran/dentaltownuk/2018May
https://www.nxtbook.com/farran/dentaltown/2018May
https://www.nxtbook.com/farran/dentaltownuk/2018April
https://www.nxtbook.com/farran/dentaltown/2018April
https://www.nxtbook.com/farran/dentaltown/2018March
https://www.nxtbook.com/farran/dentaltownuk/2018March
https://www.nxtbook.com/farran/dentaltown/2018February
https://www.nxtbook.com/farran/dentaltownuk/2018February
https://www.nxtbook.com/farran/dentaltown/2018January
https://www.nxtbook.com/farran/dentaltown/2017December
https://www.nxtbook.com/farran/dentaltownuk/2017Winter
https://www.nxtbook.com/farran/dentaltown/2017November
https://www.nxtbook.com/farran/dentaltown/2017October
https://www.nxtbook.com/farran/dentaltownuk/2017october
https://www.nxtbook.com/farran/dentaltown/NewGrad2017
https://www.nxtbook.com/farran/dentaltown/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017August
https://www.nxtbook.com/farran/dentaltown/2017August
https://www.nxtbook.com/farran/dentaltown/2017July
https://www.nxtbook.com/farran/dentaltownuk/2017July
https://www.nxtbook.com/farran/dentaltown/2017June
https://www.nxtbook.com/farran/dentaltownuk/2017may
https://www.nxtbook.com/farran/dentaltown/2017May
https://www.nxtbook.com/farran/dentaltownuk/2017April
https://www.nxtbook.com/farran/dentaltown/2017April
https://www.nxtbook.com/farran/dentaltown/2017March
https://www.nxtbook.com/farran/dentaltownuk/dentaltownuk/2017march
https://www.nxtbook.com/farran/dentaltown/February2017
https://www.nxtbook.com/farran/dentaltown/2017January
https://www.nxtbook.com/farran/dentaltown/2016December
https://www.nxtbook.com/farran/dentaltown/2016November
https://www.nxtbook.com/farran/dentaltown/2016October
https://www.nxtbook.com/farran/dentaltown/2016nge
https://www.nxtbook.com/farran/dentaltown/2016september
https://www.nxtbook.com/farran/dentaltown/2016august
https://www.nxtbook.com/farran/dentaltown/2016july
https://www.nxtbook.com/farran/dentaltown/2016june
https://www.nxtbook.com/farran/dentaltown/2016may
https://www.nxtbook.com/farran/dentaltown/2016april
https://www.nxtbook.com/farran/dentaltown/2016march
https://www.nxtbook.com/farran/dentaltown/2016february
https://www.nxtbook.com/farran/dentaltown/2016january
https://www.nxtbook.com/farran/dentaltown/2015december
https://www.nxtbook.com/farran/dentaltown/2015november
https://www.nxtbook.com/farran/dentaltown/2015october
https://www.nxtbook.com/farran/dentaltown/2015nge
https://www.nxtbook.com/farran/dentaltown/2015september
https://www.nxtbook.com/farran/dentaltown/2015august
https://www.nxtbook.com/farran/dentaltown/2015july
https://www.nxtbook.com/farran/dentaltown/2015june
https://www.nxtbook.com/farran/dentaltown/2015may
https://www.nxtbook.com/farran/dentaltown/2015april
https://www.nxtbook.com/farran/dentaltown/2015march
https://www.nxtbook.com/farran/dentaltown/2015february
https://www.nxtbook.com/farran/dentaltown/2015january
https://www.nxtbook.com/farran/dentaltown/2014december
https://www.nxtbook.com/farran/dentaltown/2014decemberb
https://www.nxtbook.com/farran/dentaltown/2014november
https://www.nxtbook.com/farran/dentaltown/2014october
https://www.nxtbook.com/farran/dentaltown/2014newgrad
https://www.nxtbook.com/farran/dentaltown/2014september
https://www.nxtbook.com/farran/dentaltown/2014august
https://www.nxtbook.com/farran/dentaltown/2014july
https://www.nxtbook.com/farran/dentaltown/2014june
https://www.nxtbook.com/farran/dentaltown/2014may
https://www.nxtbook.com/farran/dentaltown/2014april
https://www.nxtbook.com/farran/dentaltown/2014march
https://www.nxtbook.com/farran/dentaltown/2014february
https://www.nxtbook.com/farran/dentaltown/2014january
https://www.nxtbook.com/farran/dentaltown/2013december
https://www.nxtbook.com/farran/dentaltown/2013november
https://www.nxtbook.com/farran/dentaltown/2013october
https://www.nxtbook.com/farran/dentaltown/2013newgrad
https://www.nxtbook.com/farran/dentaltown/2013september
https://www.nxtbook.com/farran/dentaltown/2013august
https://www.nxtbook.com/farran/dentaltown/2013july
https://www.nxtbook.com/farran/dentaltown/2013june
https://www.nxtbook.com/farran/dentaltown/2013may
https://www.nxtbook.com/farran/dentaltown/2013april
https://www.nxtbook.com/farran/dentaltown/2013march
https://www.nxtbook.com/farran/dentaltown/2013february
https://www.nxtbook.com/farran/dentaltown/2013january
https://www.nxtbook.com/farran/dentaltown/2012december
https://www.nxtbook.com/farran/dentaltown/2012November
https://www.nxtbookmedia.com