Kazan', Kazan, Russian Federation
Kazan, Kazan, Russian Federation
Kazan, Kazan, Russian Federation
Kazan, Kazan, Russian Federation
Kazan, Kazan, Russian Federation
Subject. A review of the literature devoted to the current problem of dentistry - mucogingival anomalies (small vestibule of the mouth, short frenulum of the lips, tongue, muco-alveolar cords) is presented. Purpose of the study — study the materials of publications devoted to mucogingival anomalies as etiopathogenetic factors in the development of gingival recession. Methodology. In detail, in the light of modern ideas described mucogingival anomalies (shallow vestibule of the mouth, short frenulum of the lips, tongue, mucous-alveolar cords) and their effect on the development of gum recession. Results. It has been established that a large role in the occurrence and development of gingival recession is played by the ratio of the size of the attached and free gums, which is normally equal to 5: 1, and in pathology — 1: 1. The pathogenetic mechanism of the negative impact of mucogingival abnormalities is associated with the absence, first of all, of a sufficient width of the attached gums with a shallow vestibule of the mouth, which is a factor of constant chronic trauma to the gums with, leading to disturbances in microcirculation and tissue metabolism, resulting in resorption of bone structures, etermined radiographically. In the mechanism of gum recession, a significant role is also played by the pulling mucous-alveolar cords, shortened and massive frenum of the lips and tongue. The main signs of arising ischemic disorders are anemization and mobility of the marginal gums when the lower or upper lip, cheeks, and tongue are abducted. To prevent severe destructive lesions, it is necessary to timely identify and eliminate, with the help of vestibulo- or frenuloplasty operations, conditions conducive to functional chronic traumatization of the periodontal tissues. Conclusions. The results of the review indicate that knowledge of the anatomical and topographic parameters of the vestibule and oral mucosa is necessary to prevent the development of gingival recession, prescribe timely and adequate treatment, predict and prevent complications. However, it should be recognized that this problem, in our opinion, continues to remain relevant to this day due to the lack of an integrated approach to the prevention, diagnosis and treatment of gum recession.
mucogingival abnormalities, anatomical and topographic parameters, ischemic disorders, gingival recession
1. Abolmasov N.N. Strategiya i taktika profilaktiki zabolevaniy parodonta. Stomatologiya. 2003;4:34-39. [N.N. Abolmasov. Strategy and tactics for the prevention of periodontal disease. Dentistry. 2003;4:34-39. (In Russ.)].
2. Arsenova I.A. Vestibuloplastika svobodnymi mukoznymi transplantatami. Stomatolog. 2012;5:17-23. [I.A. Arsenova. Vestibuloplasty with free mucosal grafts. Dentist. 2012;5:17-23. (In Russ.)].
3. Artyushkevich A.S., Latysheva S.V., Naumovich S.A. Zabolevaniya parodonta. Moskva : Med. lit. 2006:328. [A.S. Artyushkevich, S.V. Latysheva, S.A. Naumovich. Periodontal disease. Moscow: Med. lit. 2006:328. (In Russ.)].
4. Borodulina I.I. Vestibuloplastika v kompleksnom lechenii zabolevaniy parodonta. Rossiyskiy stomatologicheskiy zhurnal. 2005;2:51-52. [I.I. Borodulina. Vestibuloplasty in the complex treatment of periodontal diseases. Russian dental journal. 2005;2:51-52. (In Russ.)].
5. Borodulina I.I., Robustova T.G. Rol' "tkanevogo bar'era" v mukogingival'noy hirurgii. Klassifikaciya sposobov uglubleniya preddveriya polosti rta. Rossiyskiy stomatologicheskiy zhurnal. 2005;1:15-17. [I.I. Borodulina, T.G. Robustova. The role of the "tissue barrier" in mucogingival surgery. Classification of methods for deepening the vestibule of the oral cavity. Russian dental journal. 2005;1:15-17. (In Russ.)].
6. Borodulina I.I., Kukushkin V.L., Kukushkina E.A. Epidemiologicheskie aspekty anatomicheskih osobennostey preddveriya polosti rta i ih vliyanie na razvitie patologii parodonta. Parodontologiya. 2005;1:61-65. [I.I. Borodulina, V.L. Kukushkin, E.A. Kukushkina. Epidemiological aspects of the anatomical features of the vestibule of the oral cavity and their influence on the development of periodontal pathology. Periodontics. 2005;1:61-65. (In Russ.)]. https://elibrary.ru/item.asp?id=9483490
7. Burment'eva O.S., Pylkov A.I., Burment'ev S.M. Rol' anatomo-topograficheskih i funkcional'nyh parametrov preddveriya rta v etiopatogeneze klinovidnyh defektov zubov. Rossiyskiy stomatologicheskiy zhurnal. 2009;6:15-18. [O.S. Burmentieva, A.I. Pylkov, S.M. Burmentiev. The role of anatomical, topographic and functional parameters of the vestibule of the mouth in the etiopathogenesis of wedge-shaped teeth defects. Russian dental journal. 2009;6:15-18. (In Russ.)].
8. Bykov V.L. Tkanevaya inzheneriya slizistoy obolochki polosti rta. Morfologiya. 2010;137;1:62-70. [V.L. Bykov. Tissue engineering of the oral mucosa. Morphology. 2010;137;1:62-70. (In Russ.)]. https://elibrary.ru/item.asp?id=13085934
9. Gorbatova E.A. Vliyanie topografii otdelov desny, preddveriya polosti rta, prikrepleniya uzdechek gub na formirovanie patologicheskih izmeneniy v parodonte : avtoref. dis. ... kand. med. nauk.14.01.14. Moskva, 2004:24. [E.A. Gorbatova. The influence of the topography of the gums, the vestibule of the oral cavity, the attachment of the frenum of the lips on the formation of pathological changes in the periodontium : author. dis. ... sand. med. sciences. 14.01.14. Moscow, 2004:24. (In Russ.)].
10. Grudyanov A.I., Zorina O.A. Metody diagnostiki vospalitel'nyh zabolevaniy parodonta: rukovodstvo dlya vrachey. Moskva : Med. inform. agentstvo. 2009:112. [A.I. Grudyanov, O.A. Zorina. Methods for the diagnosis of inflammatory periodontal diseases: a guide for physicians. Moscow: Med. inform. agency. 2009:112. (In Russ.)].
11. Grudyanov A.I., Makeeva M.K., Pyatigorskaya N.V. Sovremennye predstavleniya ob etiologii, patogeneze i podhodah k lecheniyu endodonto-parodontal'nyh porazheniy. Vestnik Rossiyskoy akademii medicinskih nauk. 2013;8:34-36. [A.I. Grudyanov, M.K. Makeeva, N.V. Pyatigorskaya. Modern ideas about the etiology, pathogenesis and approaches to the treatment of endodonto-periodontal lesions. Bulletin of the Russian Academy of Medical Sciences. 2013;8:34-36. (In Russ.)].
12. Grudyanov A.I, Erohin A.I. Hirurgicheskie metody lecheniya zabolevaniy parodonta. Moskva : MIA. 2006:128. [A.I. Grudyanov, A.I. Erokhin. Surgical methods for the treatment of periodontal diseases. Moscow: MIA. 2006:128. (In Russ.)].
13. Efimenko N.A., Shin F.E., Tolstyh M.P., Teplyashin A.S. Sovremennye tendencii v sozdanii biologicheski aktivnyh materialov dlya lecheniya gnoynyh ran. Voenno-medicinskiy zhurnal. 2002;1:48-52. [N.A. Efimenko, F.E. Shin, M.P. Tolstykh, A.S. Teplyashin. Modern trends in the creation of biologically active materials for the treatment of purulent wounds. Military Medical Journal. 2002;1:48-52. (In Russ.)].
14. Zavadskiy R.V. Profilaktika vospalitel'nyh oslozhneniy operaciy na al'veolyarnom otrostke : avtoref. dis. ... kand. med. nauk. 14.01.14. Moskva, 2002:26. [R.V. Zavadsky Prevention of inflammatory complications of operations on the alveolar bone : author. dis. ... cand. med. sciences. 14.01.14. Moscow, 2002:26. (In Russ.)].
15. Zelenskiy V.A., Muhoramov F.S. Detskaya hirurgicheskaya stomatologiya i chelyustno-licevaya hirurgiya. Moskva. 2006:206. [V.A. Zelensky, F.S. Mukhoramov. Pediatric surgical dentistry and maxillofacial surgery. Moscow. 2006:206. (In Russ.)].
16. Ibragim E.R., Israilov M.A., Solodova N.S. Tunnel'naya rekonstrukciya al'veolyarnogo otrostka verhney chelyusti pri deficite kostnoy tkani. Dental Forum. 2011;3:58-59. [E.R. Ibragim, M.A. Israilov, N.S. Solodova. Tunnel reconstruction of the alveolar process of the upper jaw with a deficiency of bone tissue. Dental Forum. 2011;3:58-59. (In Russ.)].
17. Lepilin A.V., Erokina N.L., Bisultanov H.U i dr. Izmenenie mikroflory polosti rta pri ispol'zovanii otechestvennyh gidroksiapatitsoderzhaschih kostno-plasticheskih materialov v lechenii parodontita. Rossiyskaya stomatologiya. 2011;6:48-50. [A.V. Lepilin, N.L. Erokina, H.U. Bisultanov et al. Changes in the microflora of the oral cavity when using domestic hydroxyapatite-containing bone-plastic materials in the treatment of periodontitis. Russian dentistry. 2011;6:48-50. (In Russ.)].
18. Modina T.N., Hamitova N.H., Mamaeva E.V., Salehova L.I. Izuchenie etiologii i patogeneza recessii desny u detey i podrostkov. Parodontologiya. 2009;3:8-14. [T.N. Modina, N.Kh. Khamitova, E.V. Mamaeva, L.I. Salekhova. Study of the etiology and pathogenesis of gum recession in children and adolescents. Periodontics. 2009;3:8-14. (In Russ.)]. https://elibrary.ru/item.asp?id=12962515
19. Miranovich S.I. Kombinirovannoe lechenie melkogo preddveriya polosti rta. Sovremennaya stomatologiya. 2008;3:40-42. [S.I. Miranovich. Combined treatment of the shallow vestibule of the oral cavity. Modern dentistry. 2008;3:40-42. (In Russ.)].
20. Modina T.N., Salehova L.I. Faktory riska razvitiya recessii desny u detey i podrostkov. Stomatologiya detskogo vozrasta i profilaktika. 2012;3:14-18. [T.N. Modina, L.I. Salekhova. Risk factors for the development of gum recession in children and adolescents. Pediatric dentistry and prevention. 2012;3:14-18. (In Russ.)]. https://elibrary.ru/item.asp?id=18336528
21. Musienko A.I. Vosstanovlenie utrachennoy desny. Institut stomatologii. 2008;1;38:82-83. [A.I. Musienko. Restoration of lost gums. Institute of Dentistry. 2008;1;38:82-83. (In Russ.)].
22. Musienko A.I., Popov A.K. Recessiya desny i metod ee ustraneniya. Institut stomatologii. 2006;30:90-91. [A.I. Musienko, A.K. Popov. Gum recession and method of its elimination. Institute of Dentistry. 2006;30:90-91. (In Russ.)]. https://elibrary.ru/item.asp?id=15267517
23. Muhaev H.H., Efimov Yu.V., Yarygina E.N. i dr. Novyy sposob vestibuloplastiki pri melkom preddverii polosti rta. Byulleten' Volgogradskogo nauchnogo centra RAMN i Administracii Volgogradskoy oblasti. 2008;2:55-56. [Kh.Kh. Mukhaev, Yu.V. Efimov, E.N. Yarygina et al. A new method of vestibuloplasty in the shallow vestibule of the oral cavity. Bulletin of the Volgograd Scientific Center of the Russian Academy of Medical Sciences and the Administration of the Volgograd Region. 2008;2:55-56. (In Russ.)].
24. Borodulina I.I., Kukushkin V.L., Kukushkina E.A., Obuhova Yu.G. O roli anatomicheskih osobennostey preddveriya polosti rta v razvitii vospalitel'nyh zabolevaniy parodonta. Zabaykal'skiy medicinskiy vestnik. 2005;1:10-12. [I.I. Borodulina, V.L. Kukushkin, E.A. Kukushkina, Yu.G. Obukhova. On the role of the anatomical features of the vestibule of the oral cavity in the development of inflammatory periodontal diseases. Zabaikalsky Medical Bulletin. 2005;1:10-12. (In Russ.)].
25. Varganova N.V., Semenihina A.I., Protopopova S.N. i dr. Opyt hirurgicheskogo lecheniya korotkih uzdechek gub i yazyka. Aktual'nye problemy sovremennoy stomatologii : materialy nauch.-prakt. konf., posvyasch. 25-letiyu stomat. f-ta Izhevskoy medakademii. Izhevsk. 2005:105-107. [N.V. Varganova, A.I. Semenikhina, S.N. Protopopova et al. Experience of surgical treatment of short frenulum of the lips and tongue. Actual problems of modern dentistry: materials of scientific and practical. conf., dedicated. 25th anniversary of stomat. Faculty of the Izhevsk Medical Academy. Izhevsk. 2005:105-107. (In Russ.)].
26. Orehova L.Yu., Shmychkova N.A. Topografo-anatomicheskie obosnovaniya provedeniya razrezov i nalozheniya shvov pri parodontologicheskih operaciyah. Parodontologiya. 2002;4:22-27. [L.Yu. Orekhova, N.A. Shmychkova. Topographic and anatomical rationale for making incisions and suturing during periodontal operations. Periodontics. 2002;4:22-27. (In Russ.)].
27. Karnickiy A.V., Garifullina A.Zh., Skripkina G.I. i dr. Ocenka sostoyaniya organov i tkaney polosti rta i otnoshenie k gigiene polosti rta u detey, obrativshihsya v kabinet skoroy stomatologicheskoy pomoschi. Stomatologicheskiy zhurnal. 2010;11;1:46-47. [A.V. Karnitskiy, A.Zh. Garifullina, G.I. Skripkina et al. Assessment of the state of organs and tissues of the oral cavity and attitude to oral hygiene in children who applied to the emergency dental office. Dental journal. 2010;11;1:46-47. (In Russ.)].
28. Pylkov A.I., Burmet'ev S.M., Burmet'eva O.S. Rol' anatomo-topograficheskih i funkcional'nyh parametrov preddveriya rta v etiopatogeneze klinovidnyh defektov zubov. Rossiyskiy stomatologicheskiy zhurnal. 2009;6:15-18. [A.I. Pylkov, S.M. Burmetyev, O.S. Burmeteva. The role of anatomical, topographic and functional parameters of the vestibule of the mouth in the etiopathogenesis of wedge-shaped teeth defects. Russian dental journal. 2009;6:15-18. (In Russ.)].
29. Modina T.N., Grigoryanc L.A., Ganzha I.R. i dr. Rol' plasticheskoy parodontal'noy hirurgii pri uvelichenii prikreplennoy desny dlya ustraneniya lokal'noy i generalizovannoy recessii. Klinicheskaya stomatologiya. 2006;2:36-39. [T.N. Modina, L.A. Grigoryants, I.R. Ganzha et al. The role of periodontal plastic surgery in the augmentation of the attached gingiva for the elimination of local and generalized recession. Clinical dentistry. 2006;2:36-39. (In Russ.)]. https://elibrary.ru/item.asp?id=9234090
30. Petah A.V., Galich S.P., Kostylev M.V. i dr. Rol' ul'trazvukovogo angioskenirovaniya v rekonstruktivnom lechenii bol'nyh s tkanevymi defektami golovy i shei. Hirurgiya Ukrainy. 2007;2:31-37. [A.V. Petakh, S.P. Galich, M.V. Kostylev et al. The role of ultrasound angioscanning in the reconstructive treatment of patients with tissue defects of the head and neck. Surgery of Ukraine. 2007;2:31-37. (In Russ.)].
31. Semenov M.G., Mirzaeva R.B. Zabolevaniya tverdyh tkaney zubov i parodonta u detey s vrozhdennoy i priobretennoy patologiey chelyustey. Institut stomatologii. 2009;2:36-37. [M.G. Semenov, R.B. Mirzaeva. Diseases of hard tissues of teeth and periodontium in children with congenital and acquired pathology of the jaws. Institute of Dentistry. 2009;2:36-37. (In Russ.)].
32. Smirnova S.S. Optimizaciya lecheniya recessii desny pacientov stoykim biotipom desny na fone vospalitel'nyh zabolevaniy parodonta. Problemy stomatologii. 2010;4:6-13. [S.S. Smirnova. Optimization of the treatment of gingival recession in patients with persistent gingival biotype against the background of inflammatory periodontal diseases. Actual problems in dentistry. 2010;4:6-13. (In Russ.)]. https://elibrary.ru/item.asp?id=15570239
33. Stepanov A.E. Frenuloplastika, vestibuloplastika i osnovnye operacii na tkanyah parodonta. Moskva : Paritet. 2000:368. [A.E. Stepanov. Frenuloplasty, vestibuloplasty and basic operations on periodontal tissues. Moscow: Parity. (In Russ.)].
34. Tkachuk O.E. Stomatologiya detskogo vozrasta. Prakticheskoe rukovodstvo. Rostov na Donu. 2006. [O.E. Tkachuk. Pediatric dentistry. A practical guide. Rostov on Don. 2006. (In Russ.)].
35. Topol'nickiy O.Z., Vasil'ev A.Yu. Atlas po detskoy hirurgicheskoy stomatologii i chelyustno-licevoy hirurgii. Moskva. 2011:259. [O.Z. Topolnitskiy, A.Yu. Vasiliev. Atlas of Pediatric Surgical Dentistry and Maxillofacial Surgery. Moscow. 2011:259. (In Russ.)].
36. Cepov L.M., Nikolaev A.I. Diagnostika i lechenie zabolevaniy parodonta. Moskva : MEDpressinform. 2002:192. [L.M. Tsepov, A.I. Nikolaev. Diagnostics and treatment of periodontal diseases. Moscow: MEDpressinform. 2002:192. (In Russ.)].
37. Cepov L.M., Nikolaev A.I. Nereshennye voprosy etiologii i patogeneza vospalitel'nyh zabolevaniy parodonta. Parodontologiya. 2001;1-2:28-31. [L.M. Tsepov, A.I. Nikolaev. Unsolved issues of etiology and pathogenesis of inflammatory periodontal diseases. Periodontics. 2001;1-2:28-31. (In Russ.)].
38. Heliövaara A., Rantanen I., Arte S. Dental development and tooth agenesis in children with velocardiofacial syndrome // Int J Paediatr Dent. - 2011;21(6):446-450.
39. Lorenzoni M., Wimmer G. Asthetische Implantologie -eine Symbiose aus Chirurgie, Parodontologie und Prothetik // Novoe v stomatologii. - 2007;5:44-49.
40. McDonald R.E. Dentistry for child and adolescens. Moscow : Med. inform. Agentstvo. 2004:770.
41. Park J.B. Correcting the frenal pull and increasing the width of keratinized mucosa around endosseous implants using denudation procedure // Indian J Dent Res. - 2008;19(4):362-365.
42. Rotstein I., Simon J.H. The endo-perio lesion: a critical appraisal of the diseases condition // Endodontic Topics. - 2006;13:34-56.
43. Shetye P.R., Caterson E.J., Grayson B.H., McCarthy J.G. Soft-tissue profile changes following early Le Fort III distraction in growing children with syndromic craniosynostosis // Plast Reconstr Surg. - 2013;132(4):945-954.
44. Pitts N.B., Boyles J., Nugent Z.J. et al. The dental caries experience of 5-year-old children in Great Britain (2005/6). Surveys coordinated by the British Association for th study of community dentistry // Community Dent Health. - 2007;24(1):59-63.