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Results for “Gingival Recession”

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PubMed2002

The extent and correlates of gingival recession in non-institutionalised Thai elderly.

The purpose of this study was to describe the extent and distribution of gingival recession in Thai elderly. As part of a longitudinal geriatric oral health study, 453 community-dwelling dentate subjects, 51-92 years of age, were examined at baseline in 1999. All remaining teeth were measured on four periodontal sites to assess the amount of gingival recession. The percentage of sites with recession increased with age from 49.6% in 51-59 years of age to 72.0% in 70+ years of age (P < 0.001). Males exhibited greater levels of recession than females (P < 0.001). Regression analysis for the percentage of buccal sites with recession showed that recession was associated with age, gender, cervical abrasion, and amount of calculus (R2 = 0.15, P < 0.001). However, the regression model for the percentage of all sites with recession did not find an association between recession and cervical abrasion. Hence, it appears that gingival recession on different locations may involve different processes.

Age Factors↗

PubMed1998

Resorbable barrier and envelope flap surgery in the treatment of human gingival recession defects. Case reports.

The present case report evaluates the treatment outcome following mucogingival surgery combined with a bioresorbable barrier in gingival recession defects in humans. A total of 11 buccal, Miller Class I or II, gingival recession defects in 6 patients were consecutively treated. The exposed root surface was ultrasonically scaled and conditioned with a tetracycline HCl solution (10 mg/ml) for 4 min. A buccal full/split thickness envelope flap was then elevated, and a bioresorbable matrix barrier was positioned to completely cover the exposed root surface and surrounding bone margins. A flap was then positioned at or slightly coronal to its original position. In all cases, a variable amount of membrane was intentionally left uncovered on the exposed root surface. Clinical recordings, assessed presurgery and at 6 months postsurgery, included defects-specific plaque and gingival scores, recession depth (RD), probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KT). Immediately postsurgery, and at weeks 1, 2, 4, 6 and 8 postsurgery, the location of gingival margin or granulation tissue covering the previously exposed root surface was recorded, as well as the extent of barrier exposure. Statistical analysis showed that RD decreased from 2.3+/-0.2 mm presurgery to 0.8+/-0.5 mm at 6 months postsurgery (p=0.001), representing a mean root coverage of 65% (range: 40-100%). CAL gain paralleled RD reduction (1.5+/-0.5 mm; p=0.0009), while KT showed a slight increase (0.3+/-0.6 mm) at 6 months postsurgery. Results indicate that clinical improvement of gingival recession defects may be achieved by means of a barrier-supported envelope technique. The bioresorbable matrix barrier represented an effective scaffold to support the reconstruction of the mucogingival unit.

Adult↗

PubMed1998

Long-term stability of the mucogingival complex following guided tissue regeneration in gingival recession defects.

The purpose of the present study was to evaluate the stability of soft tissue conditions in gingival recession defects treated with guided tissue regeneration (GTR). The study population was selected among those patients who had been treated with GTR procedures for Miller's class I or II, deep (> or =3 mm), buccal gingival recession defects. Defects were included only when they had revealed recession depth reduction > or =2 mm and root coverage > or =60% at 6 months following GTR treatment. These defects were regarded as successfully treated and scheduled for further monitoring. 20 patients, 11 male and 9 female, aged 23 to 57 years (mean age: 33.2 years), each contributing 1 defect, were selected. 9 patients were smokers (> or =10 cigarette per day). Recession depth (RD), probing depth (PD), clinical attachment level (CAL), and width of keratinized gingiva (KG) were assessed immediately before surgery, at 6 months post-surgery (baseline examination), and at 4 years post-surgery (4-year examination). At baseline examination, RD reduction was 3.6+/-0.9 mm (mean root coverage: 80%). CAL gain amounted to 4.2+/-1.3 mm, 60% of the defects showing CAL gain > or =4 mm. KG increased from 1.9+/-1.2 mm at presurgery examination to 3.1+/-0.9 mm at baseline examination. At 4-year examination, no significant changes from baseline RD, CAL and KG recordings were observed. Differences in baseline-4 year changes between smokers and non-smokers were not statistically significant. The results of the present study demonstrate that clinical outcome achieved following GTR procedure in gingival recession defects can be maintained over periods up to 4 years.

Adult↗

PubMed2003

Surgical treatment of gingival recessions using emdogain gel: clinical procedure and case reports.

This article describes the clinical procedure and outcome of surgical treatment of gingival recessions with the adjunctive use of Emdogain gel, an enamel matrix derivative bioactive material for periodontal reconstructive surgery. Six cases with gingival recession on maxillary canines are presented with 12 months of follow-up. Initial gingival recession averaged 4.8 mm, with a mean probing pocket depth of 2.2 mm. At the 12-month follow-up, a mean of 3.5 mm of root coverage was observed (ie, 73% root coverage, range 60% to 100%). Probing pocket depth averaged 1.7 mm, indicating a 4-mm gain of clinical attachment (range 3 to 5 mm). On a clinical level, mucogingival surgery in combination with the application of Emdogain gel results in predictable root coverage and gain of clinical attachment while maintaining shallow pockets.

Adult↗

PubMed2005

Coronally positioned flap procedures with or without a biodegradable membrane in the treatment of human gingival recession. A 6-year follow-up study.

BACKGROUND: Short-term data have indicated that treatment of gingival recession type defects by coronally positioned flap procedures with or without biodegradable membranes may result in similar treatment outcome. The aim of this study was to compare 12-month and 6-year follow-up results for these two treatment approaches. METHODS: Twenty patients with buccal bilateral Miller Class I or Class II gingival recession defects in cuspids or bicuspids were treated randomly by coronally positioned flap alone (20 sites) or in combination with a biodegradable membrane (20 sites). Clinical measurements at baseline, 6, 12 months and 6 years included apical extent of gingival recession, width of the defect at the cemento-enamel junction (CEJ), width of keratinized tissue, as well as attachment level and probing depth. Eleven patients were available for the 6-year evaluation. RESULTS: At 12 months (20 sites), both treatments resulted in significant gain of root coverage (p<0.001), stable probing depth, and increased attachment level (p<0.001). The 6-year evaluation (11 sites) showed a significant gain of root coverage for the non-membrane group only (p<0.05). No significant between-group differences were detected for any other treatment variable regardless of smoking status (p>0.05). Compared with baseline, the 6-year results showed that seven membrane sites gained root coverage, three were unchanged and one lost root coverage. For the 11 non-membrane sites, eight gained root coverage, and three were unchanged. The five membrane and the 10 non-membrane sites exhibiting complete root coverage at 6 months were reduced to two and one, respectively, at the 6-year evaluation. CONCLUSIONS: The coronally positioned flap procedure offers a simple and reliable treatment alternative as a root coverage procedure in Class I and Class II recession type defects. Placement of a biodegradable membrane underneath the flap does not seem to improve neither the short- nor the long-term results. Long-term outcome stability seems to be critically dependent on a continuous follow-up program with re-instruction in non-traumatic brushing habits.

Absorbable Implants↗

PubMed1983

Gingival recession in the mandibular central incisor region of Saudi schoolchildren aged 10-15 years.

Incidence of gingival recession in the mandibular central incisor region was examined in a sample of 1336 male and female Saudi schoolchildren aged from 10-15 yr. Gingival recession was found in 9.88% with no significant difference in the affected teeth by age (p greater than 0.8361). There was a significant difference in the mean clinical crown length between the affected and adjacent teeth (p less than 0.0001). The highest significant association of gingival recession was found with inflammation (p less than 0.0001), anterior crowding (p less than 0.0009) and frenal involvement (p less than 0.0001). The results of this investigation suggest that future studies should be made to evaluate the effect of miswak as a cleansing agent for the gingival tissues among the Saudi population.

Adolescent↗

PubMed1997

Healing response of gingival recession defects following guided tissue regeneration procedures in smokers and non-smokers.

This retrospective study evaluated healing response in gingival recession defects following guided tissue regeneration (GTR) in smokers. 22 systemically healthy patients who had been treated for deep (> or = 4 mm), buccal, Miller's class I or II gingival recession defects with ePTFE membranes were included. Patients were regarded as smokers if they smoked more than 10 cigarettes/day at the time of surgical procedure. Occasional and former smokers were excluded. 9 patients (6 male, mean age 29 years) were smokers, while 13 patients (4 male, mean age 35 years) were non-smokers. Clinical parameters, recorded presurgery and at 6 months postsurgery, included defect-specific plaque (DP1) and bleeding on probing (BoP) scores, recession depth (RD), probing depth (PD), clinical attachment level (CAL), and keratinized tissue width (KG). Extent of membrane exposure (ME) and newly formed tissue (NFT) gain were assessed at membrane removal. Statistical analysis revealed no significant differences between smokers and non-smokers in demographic and presurgery defect characteristics. DP1 and BoP scores were similar presurgery and remained almost unchanged throughout the observation interval in both groups. ME was significantly greater in smokers (2.6 +/- 1.4 mm) than in non-smokers (1.3 +/- 0.6 mm). NFT gain was 2.8 +/- 1.0 mm in smokers and 3.6 +/- 1.4 mm in non-smokers, the difference being not statistically significant. Smokers showed significantly less RD reduction and root coverage (2.5 +/- 1.2 mm and 57%, respectively) compared to non-smokers (3.6 +/- 1.1 mm and 78%, respectively). In conclusion, the results indicate that treatment outcome following GTR in gingival recession defects is impaired in cigarette smokers.

Adult↗

PubMed1999

Adverse effects associated with a bioabsorbable guided tissue regeneration device in the treatment of human gingival recession defects. A clinicopathologic case report.

This clinicopathologic case report documents an adverse effect associated with the use of a polylactic acid-based barrier in the treatment of human gingival recession defects. A total of 27 consecutively treated patients, in whom guided tissue regeneration with a polylactic acid barrier was used to correct gingival recession defects, were evaluated. This adverse effect consisted of a midradicular-apical swelling, generally asymptomatic, with no apparent predilection for gender, age, tooth type or location (maxilla/mandible), or surgical procedure. It was observed in 14 of 27 (52%) patients and 22 of 41 (54%) defects. The swelling decreased in size over time and in most cases, it completely resolved within 12 months postsurgery. Histopathologic evaluation of a 14-week specimen indicated characteristics (multinucleated giant cells, foamy macrophages) consistent with a foreign body reaction. These findings suggest that patients undergoing GTR procedures with synthetic absorbable devices for the treatment of gingival recession defects should be advised of the possible occurrence of such an adverse effect.

Absorbable Implants↗

PubMed2006

Prevalence and risk of traumatic gingival recession following elective lip piercing.

The aims of this study were to evaluate the prevalence, risk and odds ratios of gingival recession defects associated with elective lip piercing and wearing of stud jewelry, and to attempt to identify risk factors that might permit the incidence of recession and its severity to be predicted, using Miller's classification. Ninety-one subjects with lip piercing and labrets were evaluated with regard to gender, age, smoking history, orthodontic history, and labret characteristics. An age-matched group of 54 individuals without peri-oral piercing provided the control. Gingival recession was recorded on teeth opposing a labret in 68.13% of pierced subjects. By contrast, only 22.2% of unpierced individuals demonstrated recession. The odds ratio between pierced and control groups indicates a likelihood of recession 7.5 times greater in a pierced individual wearing a labret than in an unpierced individual. Logistical regression analysis showed that age, gender, smoking and labret configuration did not significantly influence the development of recession. Furthermore, an illustrative example indicates that piercing and provision of a labret might typically increase the risk of recession occurring from 34.4% (pre-piercing) to 80.8 %. Recession severity was greater in the pierced group, with Miller's class 2 and 3 defects observed in 18.7% of the pierced but not at all in the unpierced group. Ordinal regression identified previous orthodontic treatment as the only significant predictor of Miller's grade. We concluded that a clear link exists between lip piercing, labret use and gingival recession. Belief that labret placement and configuration can be modified to provide protection is unfounded.

Adult↗

PubMed2006

Connective tissue grafting on resin ionomer in localized gingival recession.

BACKGROUND: One of the main objectives of periodontal reconstructive surgery is the coverage of exposed roots that occur due to gingival recession. On some occasions, where a caries, root resorption, or amalgam restoration exists on the exposed root surface, the treatment planning becomes more complex. This case report describes the use of a subepithelial connective tissue graft (SCTG) on a resin ionomer-restored root surface to treat gingival recession that is complicated with the above-mentioned handicaps. METHODS: An amalgam restoration and carious lesion were removed following full-thickness flap reflection, and the cavity was restored with glass ionomer cement. An SCTG was placed onto the restoration, and the flap was coronally positioned. A porcelain crown restoration was performed 9 months after surgery. RESULTS: At 3-, 6-, and 9-month follow-ups, probing depths were reduced and gain in attachment level was obtained with no clinical signs of inflammation in gingiva. Monthly periodontal controls revealed that creeping attachment had occurred on the restoration during the follow-up periods. CONCLUSION: This single case report serves as a good example to show that SCTG can be successfully performed to treat gingival recession associated with a glass ionomer-restored root surface.

Adult↗

PubMed1980

Gingival recession in the lower incisor region of 15-year-old subjects.

A sample of 1,003 children, aged 15 years, were examined for prevalence of gingival recession. It was found that 17% had pseudo gingival recession and 1% had true recession. The highest degree of association with local etiological factors was that between recession and the width of keratinized gingiva; frenal pull was the second most highly associated factor followed by tooth arch relationship and the least association existed between plaque and gingival recession. There was no association between calculus and recession.

Adolescent↗

PubMed2007

Cross-sectional evaluation of the presence of gingival recession in individuals with cleft lip and palate.

BACKGROUND: In dentistry, investigations in the field of periodontics in individuals with cleft lip and palate are scarce, with few studies on the prevalence, incidence, extension, and severity of periodontal alterations and their treatment in adults. METHODS: This study analyzed the prevalence, extension, and severity of recessions and the relationship with some etiologic factors in 200 individuals with cleft lip and palate aged 13 to 56 years. Examination comprised measurements of gingival recession, amount of keratinized mucosa, frenum insertions, and tooth positioning in the dental arch. RESULTS: Analysis of the results revealed that the prevalence of recession was high, because 75% of individuals in the sample had at least one tooth with gingival recession; 100% of individuals aged >43 years presented at least one recession, and most recessions were Miller Class I. The multiple linear regression demonstrated that recession is directly proportional to age (i.e., it increases with age); concerning the amount of keratinized mucosa, the proportion is inverse (i.e., the larger the recession, the smaller the amount of mucosa); and gingival inflammation also presented a positive correlation. CONCLUSIONS: Gingival recessions are caused by many etiologic factors, which usually act in combination. Thus, all factors causing recession should be analyzed so that planning and treatment of this clinical condition may be established, for achievement of optimal outcomes.

Adolescent↗

PubMed1986

Gingival recession in schoolchildren at 7, 12 and 17 years of age in Espoo, Finland.

The present study was undertaken in response to a growing concern among clinicians about an increase in gingival recession among children and adolescents. Groups of 50 boys and 50 girls aged respectively 7, 12, and 17 yr were examined at Espoo Health Centre in 1983. Gingival recession was measured on the facial and lingual aspects of all permanent teeth. Whenever the gingival margin was located on root cementum, the distance from the gingival margin to the enamel border was measured to the nearest 0.5 mm. Recession was categorized as "slight" (0.5 or 1 mm) or "extensive" (1.5-3.5 mm). The prevalence of gingival recession was 5% at 7 yr, 39% at 12 yr, and 74% at 17 yr of age. More girls than boys had recession in the two youngest age groups. At 17 yr recession was equally common in both sexes and both "slight" and "extensive" recession was most often recorded on facial surfaces of first molars, premolars and canines. The alarmingly high prevalence of gingival recession at young age warrants further study of both the reasons and the consequences of early cementum exposure.

Adolescent↗

PubMed1991

The effect of an anticalculus dentifrice on calculus formation and gingival recession in Thai children and teenagers: one-year study. Study #1. An anticalculus dentifrice containing 3.3% soluble pyrophosphate and 1.0% of a copolymer.

A one-year, double-blind clinical study was conducted on a population of Thai children and teenagers to determine the effect of the twice daily use of an anticalculus dentifrice on supragingival calculus formation and gingival recession, as compared to the use of a placebo dentifrice and the continuation of customary oral hygiene procedures. The subjects were initially evaluated for calculus using the Volpe-Manhold procedure and for gingival recession using the GRT procedure of Volpe, Triratana, and Rustogi. All subjects received an oral prophylaxis and were assigned to the use of 1) a placebo dentifrice containing 0.243% sodium fluoride in a silica base, 2) an anticalculus dentifrice containing 3.3% soluble pyrophosphate and 1.0% Gantrez copolymer--in a 0.243% sodium fluoride/silica base, or 3) continuation of customary oral hygiene procedures. After one year, the subjects using the anticalculus dentifrice had 37.01% less supragingival calculus and 25.09% less gingival recession than the subjects using the placebo dentifrice. Additionally, after one year, the subjects using the anticalculus dentifrice had 34.86% less supragingival calculus and 29.95% less gingival recession than the subjects who continued their customary oral hygiene procedures. All reductions were statistically significant at the 95% or greater level of confidence.

Adolescent↗

PubMed1991

The effect of an anticalculus dentifrice on calculus formation and gingival recession in Thai children and teenagers: one-year study. Study #2. An anticalculus dentifrice containing 1.3% soluble pyrophosphate and 1.5% of a copolymer.

A one-year, double-blind clinical study was conducted on a population of Thai children and teenagers to determine the effect of the twice daily use of an anticalculus dentifrice on supragingival calculus formation and gingival recession, as compared to the use of a placebo dentifrice and the continuation of customary oral hygiene procedures. The subjects were initially evaluated for calculus using the Volpe-Manhold procedure and for gingival recession using the GRT procedure of Volpe, Triratana, and Rustogi. All subjects received an oral prophylaxis and were assigned to the use of the following: (1) a placebo dentifrice containing 0.243% sodium fluoride in a silica base, (2) an anticalculus dentifrice containing 1.3% soluble pyrophosphate and 1.5% Gantrez copolymer in a 0.243% sodium fluoride/silica base, or (3) continuation of customary oral hygiene procedures. After six months, the subjects using the anticalculus dentifrice had 35.93% less supragingival calculus than the placebo dentifrice subjects, and 52.74% less supragingival calculus than the subjects who continued their regular/customary oral hygiene procedures. After one year, the subjects using the anticalculus dentifrice had 39.76% less supragingival calculus and 18.33% less gingival recession than the subjects using the placebo dentifrice. Also, after one year, the subjects using the anticalculus dentifrice had 57.86% less supragingival calculus and 16.55% less gingival recession than the subjects who continued their customary oral hygiene procedures. All reductions were statistically significant at the 99% level of confidence.

Adolescent↗

PubMed1999

Gingival recession and toothbrushing in an Italian School of Dentistry: a pilot study.

The aim of this pilot study was to evaluate the prevalence of gingival recession at buccal tooth surfaces in a student population of Bologna University Dental School. A total of 55 subjects, attending the 1st and 5th year of the course were examined. The clinical examination involved assessment of plaque, calculus, width of keratinized gingiva, buccal probing depth and buccal gingival recession. Information about toothbrushing behavior was collected in an interview. The multiple regression analysis showed that level of education (p=0.002), toothbrushing technique (p=0.013) and toothbrushing frequency (p=0.016) are significant contributors to gingival recession. Notwithstanding the limits of a preliminary study, a higher prevalence of buccal recession is observed in the final year students, which have also a significantly lower % of buccal surfaces with calculus (p=0.014). In addition, it clearly appears that there is the necessity to investigate other factors connected with toothbrushing (pressure, time, toothpaste quantity) in order to provide an oral hygiene education without undesired effects.

Adult↗

PubMed1998

Subpedicle connective tissue graft versus guided tissue regeneration with bioabsorbable membrane in the treatment of human gingival recession defects.

The purpose of the present clinical study was to evaluate the effect of guided tissue regeneration (GTR) in comparison to subpedicle connective tissue graft (SCTG) in the treatment of gingival recession defects. A total of 12 patients, each contributing a pair of Miller's Class I or II buccal gingival recessions, was treated. According to a randomization list, one defect in each patient received a polyglycolide/lactide bioabsorbable membrane, while the paired defect received a SCTG. Treatment effect was evaluated 6 months postsurgery. Clinical recordings included full-mouth and defect-specific oral hygiene standards and gingival health, recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), and keratinized tissue width (KT). Mean RD significantly decreased from 3.1 mm presurgery to 1.5 mm at 6 months postsurgery for the GTR group (48% root coverage), and from 3.0 mm to 0.5 mm for the SCTG group (81% root coverage). RD reduction and root coverage were significantly greater in SCTG group compared to GTR group. Mean CAL gain amounted to 1.7 mm for the GTR group, and 2.3 mm in the SCTG group. No significant differences in PD changes were observed within and between groups. KT increased significantly from presurgery for both treatment groups, however gingival augmentation was significantly greater in the SCTG group compared to GTR group. Results indicate that: 1) treatment of human gingival recession defects by means of both GTR and SCTG procedures results in clinically and statistically significant improvement of the soft tissue conditions of the defect; and 2) treatment outcome was significantly better following SCTG compared to GTR in terms of recession depth reduction, root coverage, and keratinized tissue increase.

Absorbable Implants↗

PubMedDate not supplied

Utilization of a resorbable collagen membrane in repairing gingival recession defects.

Predictable coverage of exposed root surfaces and the corresponding treatment of gingival recession defects remain important objectives of periodontal therapy. A variety of techniques have been developed during the past several decades to address this common clinical challenge. Traditional surgical approaches have been relatively successful in achieving root coverage. Attempts have been made recently to achieve root coverage with surgical techniques based on the principles of guided tissue regeneration, using resorbable and nonresorbable materials. The learning objective of this article is to present case documentations of root coverage, using a resorbable collagen barrier. The results achieved illustrate the potential of this material in the treatment of gingival recession. The biologic properties of collagen as a barrier material, the surgical approach, and the principles of case selection are reviewed.

Adult↗