Stillman’s cleft, also known as Stillman’s triangle, is a specific type of mucogingival defect that occurs predominantly on the buccal (cheek) surface of a tooth root. It was first described by Dr. Stillman as a recession that is often associated with occlusal trauma, which refers to excessive force or pressure on the teeth during biting and chewing. This trauma can occur due to various reasons, such as malocclusion (misalignment of the teeth), bruxism (grinding or clenching of the teeth), or habits like nail biting.
The cleft itself appears as a triangular-shaped area of recession in the gum tissue, with the apex of the triangle pointing towards the gingival margin (gum line) and the base extending towards the tooth root. It is typically found in the posterior (back) regions of the mouth, most commonly affecting the premolars and molars.
Stillman’s cleft can occur in individuals with either marginal gingivitis or mild periodontitis. Marginal gingivitis refers to inflammation of the gum tissue around the teeth, often caused by poor oral hygiene and the accumulation of plaque and tartar. Periodontitis, on the other hand, is a more advanced stage of gum disease characterized by the loss of supporting structures such as the bone and connective tissue that hold the teeth in place.
The presence of occlusal trauma in conjunction with gingival inflammation or mild periodontitis can lead to the development of Stillman’s cleft. The excessive force exerted on the teeth during biting and chewing can cause the gum tissue to recede, resulting in the triangular-shaped defect. Additionally, the inflammation and destruction of the supporting structures caused by gum disease can further contribute to the development of the cleft.
It is important to note that Stillman’s cleft is not a common finding and is usually associated with specific clinical situations. Its occurrence may vary among individuals, and not everyone with occlusal trauma or gum disease will develop a cleft. However, when present, it can be an indication of an underlying problem that requires attention, such as occlusal adjustment to alleviate excessive forces on the teeth or periodontal therapy to address gum disease.
Stillman’s cleft is a mucogingival defect characterized by a triangular-shaped recession predominantly seen on the buccal surface of a tooth root. It is often associated with occlusal trauma in conjunction with marginal gingivitis or mild periodontitis. Its occurrence can vary among individuals, and its presence may indicate the need for specific interventions to address the underlying issues contributing to its development.