Parameters of Care Summary - Mucogingival Conditions
- Deviations from the normal anatomic relationship between the gingival margin and the mucogingival junction (MGJ).
- Absence or reduction of keratinized tissue
- Probing depths extending beyond the mucogingival junction
Anatomical variations that may complicate management:
- Tooth position
- Frenulum insertions
- Vestibular depth
Features of the exam:
- Medical history
- Dental history, including chief complaint
- Relative findings from probing and visual examination of periodontium and soft tissue
- Radiographs where appropriate (although radiographs do not detect mucogingival problems)
- Mucogingival relationships identifying deficiencies of keratinized tissue, abnormal frenulum insertions, and other tissue abnormalities
- Etiologic factors
- Variations in ridge configuration
- Mucogingival therapy is defined as non-surgical and/or surgical correction of defects in morphology, position, and/or amount of soft tissue and underlying bone.
- Help maintain the dentition or its replacements in health with good function and esthetics.
- May include restoring anatomic form and function.
- Reduce the risk of progressive recession.
- May be accomplished with a variety of procedures including root coverage, gingival augmentation, pocket reduction, and ridge reconstruction, as well as control of etiologic factors.
- Several mucogingival conditions may occur concurrently, necessitating the consideration of combining or sequencing surgical techniques.
- In order to monitor changes of mucogingival conditions, baseline findings should be recorded.
- The selection of surgical procedures may depend on the configuration of the defect, availability of donor tissue, and esthetic considerations of the patient.
- Depending on the mucogingival conditions, the following treatments may be indicated:
- Control of inflammation through plaque control, scaling and root planing, and/or antimicrobial agents
- Gingival augmentation therapy
- Root coverage
- Crown lengthening
- Extraction site grafts to prevent ridge collapse
- Papilla regeneration
- Exposure of unerupted teeth
- Surgical procedures to reduce probing depths
- Tooth movement
- Vestibular depth alteration
- Gingival augmentation and/or vestibuloplasty
- Ridge augmentation
- Ridge defects that may need correction prior to prosthetic rehabilitation can be treated by a variety of tissue grafting techniques and/or guided tissue regeneration.
- Correction of the mucogingival condition
- Cessation of further recession
- Tissues free of clinical signs of inflammation
- Return to function in health and comfort
- Satisfactory esthetics
- Persistence of the mucogingival problem
- Persistence of clinical signs of inflammation
- Less than satisfactory esthetics
- In patients where the condition did not resolve, additional therapy may be required.
- Not all patients or sites will respond equally or acceptably.
- Additional therapy may be warranted on a site specific basis.
Source: Journal of Periodontology, Volume 71 Number 5, May 2000 (Supplement)
Parameters are available for download from the AAP web site.