620H
Fig. 11.6 Traumatic gingival injury
inflicted by the fingernail (arrowed) that
has been teased from the gingival crevice
of 1|. (Reproduced with kind permission
of the Editor, British Dental Journal and
Mr P. R. Greene, General Dental
Practitioner, Manchester.)621H
Fig. 11.7 (a) Generalized, self-inflicted
ulceration of the attached gingiva and
extensive loss of attachment around |6.
(b) Ulcerative lesion at the hairline on
the scalp. The lesions were produced by
rubbing with a fingernail. (Reproduced
with kind permission of the Editor,
Journal of Periodontology.)11.7 MUCOGINGIVAL PROBLEMS IN CHILDREN
In adults much attention has focused on whether recession is more likely to occur
locally where there is a reduced width of keratinized gingiva (KG). Conversely, of
course, gingival recession inevitably leads to a narrowing of the zone of KG. It is,
therefore, often difficult to determine unequivocally whether a narrow zone of KG is
the cause or the effect of recession. A narrow or finite width of KG is compatible with
gingival health, providing the tissues are maintained free of inflammation and
chronic, traumatic insult. A wider zone of KG is considered more desirable to
withstand gingival inflammation, trauma from mastication, toothbrushing, and forces
from muscle pull.