

Contemporary approach in gingival recession treatment
Gingival recession is defined as the displacement of marginal tissue apical to the cementoenamel junction. New classification of gingival recessions is important not only for shaping diagnosis, prognosis, and treatment planning but also communication between clinicians. Furthermore, using the classification system it is possible to predict the final recession reduction with a high level of confidence, thus supporting the importance of analyzing baseline interdental clinical attachment loss to assess the prognosis of gingival recession treatment.
The etiology of gingival recession is multicausal. Gingival inflammation, excessive tooth brushing, muscle and frena pull are the major causes in gingival recession development. Additional predisposing factors for gingival recession include areas with thin, minimal or no keratinized tissue, orthodontic movement leading to buccal tooth displacement, direct trauma associated with class II malocclusion, and acute infection with herpes simplex virus.
Complete root coverage is the main goal in the treatment of mucogingival recession. The major indications for root-coverage procedures are esthetic requests, treatment of dental sensitivity, and increase of keratinized tissue to reduce the risk of defect progression.
It is reported that coronally advanced flap (CAF) may benefit from newer variations on the technique and from the additional use of grafting. The use of a connective tissue graft in conjunction with a coronally advanced flap procedure was accepted as a reliable method to obtain root coverage and improve esthetics. In this lecture different coronally advanced flaps and grafting procedures will be described and decision-making tree will be discussed.
Dr Natasa Nikolic Jakoba is Full Professor of Periodontology at the Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Serbia. She is actively involved in under- and post-graduate studies and continuing medical education. She received her DDS from the University of Belgrade, School of Dental Medicine in 2001. She completed a three-year residency in periodontologyin 2007 at the University of Belgrade, Serbia. She received her M. Sc. degree in Periodontology (Topic: Effects of β-tricalciumphosphate in alveolar ridge preservation) at the School of Dental Medicine, University of Belgrade in 2007.She defended her Ph.D. thesis in Periodontology (Title of thesis: Characterization of A. actinomycetemcomitans isolates) in 2012. at the School of Dental Medicine, University of Belgrade. From 2011. she is a member of the board of the Serbian Society of Periodontology. In 2015. sheworked as a guest researcher at Section of Oral Radiology, Department of Dentistry, Aarhus University, Denmark.Her research interests focus on plastic-esthetic periodontal surgery, use of CBCT in diagnosis of periodontal lesions, etiopathogenetic and pathophysiological mechanisms in periodontitis.
Natasa Nikolic Jakoba, DDS, MSc, PhD
Full Professor
School of Dental Medicine, Department of Periodontology
University of Belgrade
DrSubotica 4, Belgrade, Serbia
Phone: +381638269909
Fax: +38113065463
Email: natasa.nikolic.jakoba@stomf.bg.ac.rs
Contemporary approach in gingival recession treatment
Gingival recession is defined as the displacement of marginal tissue apical to the cementoenamel junction. New classification of gingival recessions is important not only for shaping diagnosis, prognosis, and treatment planning but also communication between clinicians. Furthermore, using the classification system it is possible to predict the final recession reduction with a high level of confidence, thus supporting the importance of analyzing baseline interdental clinical attachment loss to assess the prognosis of gingival recession treatment.
The etiology of gingival recession is multicausal. Gingival inflammation, excessive tooth brushing, muscle and frena pull are the major causes in gingival recession development. Additional predisposing factors for gingival recession include areas with thin, minimal or no keratinized tissue, orthodontic movement leading to buccal tooth displacement, direct trauma associated with class II malocclusion, and acute infection with herpes simplex virus.
Complete root coverage is the main goal in the treatment of mucogingival recession. The major indications for root-coverage procedures are esthetic requests, treatment of dental sensitivity, and increase of keratinized tissue to reduce the risk of defect progression.
It is reported that coronally advanced flap (CAF) may benefit from newer variations on the technique and from the additional use of grafting. The use of a connective tissue graft in conjunction with a coronally advanced flap procedure was accepted as a reliable method to obtain root coverage and improve esthetics. In this lecture different coronally advanced flaps and grafting procedures will be described and decision-making tree will be discussed.
Dr Natasa Nikolic Jakoba is Full Professor of Periodontology at the Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Serbia. She is actively involved in under- and post-graduate studies and continuing medical education. She received her DDS from the University of Belgrade, School of Dental Medicine in 2001. She completed a three-year residency in periodontologyin 2007 at the University of Belgrade, Serbia. She received her M. Sc. degree in Periodontology (Topic: Effects of β-tricalciumphosphate in alveolar ridge preservation) at the School of Dental Medicine, University of Belgrade in 2007.She defended her Ph.D. thesis in Periodontology (Title of thesis: Characterization of A. actinomycetemcomitans isolates) in 2012. at the School of Dental Medicine, University of Belgrade. From 2011. she is a member of the board of the Serbian Society of Periodontology. In 2015. sheworked as a guest researcher at Section of Oral Radiology, Department of Dentistry, Aarhus University, Denmark.Her research interests focus on plastic-esthetic periodontal surgery, use of CBCT in diagnosis of periodontal lesions, etiopathogenetic and pathophysiological mechanisms in periodontitis.
Natasa Nikolic Jakoba, DDS, MSc, PhD
Full Professor
School of Dental Medicine, Department of Periodontology
University of Belgrade
DrSubotica 4, Belgrade, Serbia
Phone: +381638269909
Fax: +38113065463
Email: natasa.nikolic.jakoba@stomf.bg.ac.rs
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