In modern medicine, marginal gingival tissue
recession is becoming a common concern of the patient often requiring treatment
for aesthetic reasons. Deep recessions often affecting the anterior teeth in
young age group is significantly associated with patient request for treatment.

The displacement
of the soft tissue margin apical to the cementoenamel junction (CEJ) not only exposes the root surface but also impairs
the aesthetics. Marginal gingival tissue recession is associated with several
factors with complex etiology. Traumatic
tooth brushing is considered as one of the main causative factor for the development
of recessions commonly creating a wedge shaped defect at cervical area. A
five year study showed that with the level of oral hygiene education,
probability of gingival recession also increases.1

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the exact mechanism of gingival recession is not well understood. Risk factors considered
to be associated with gingival recession include tooth
malposition, path of eruption, tooth shape, profile and position in the arch,
alveolar bone dehiscence, muscle attachment and frenal pull, periodontal
disease and treatment, iatrogenic restorative or operative treatment, improper
oral hygiene methods (e.g. tooth brushing, floss, interproximal brush) and
other self-inflicted injuries (e.g. oral piercing) while the most important
factor increasing the risk of gingival recession may be a thin gingival biotype
where a delicate marginal tissue is covering a non-vascularized root surface.4


Gingival recession of 1 mm or more at one or more
sites is one of the common finding seen in More than 50% of the population. It
is prevalent in patients with good as well as poor oral hygiene. Buccal
surfaces are often involved in patients with good oral hygiene, whereas all
tooth surfaces get affected in patients suffering from periodontal disease or
after periodontal treatment. 5,6,7

Gingival recession has also been linked to
ethnicity. It has been seen that Mexican Americans and non-Hispanic whites exhibited lesser prevalence
and extent of gingival recession compared to non-Hispanic blacks.7
Refuting this observation no difference in terms of prevalence of gingival
recession was found between whites and non-whites in an epidemiological study.3

The extent and prevalence of gingival recession
increases with age. As compared to females, males have shown to exhibit greater
levels of recession. 3 The association  of tobacco smoking in the etiology and
prevalence of recession as discussed by several authors is controversial.
However, more extensive recessions were seen in smokers than non-smokers in
some studies.3


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