Prevalence and clinical characteristics of gingival recession in patients with periodontitis

Abstract

Summary. One of the main aesthetic concerns in patients with periodontitis is gingival recession, which is characterized by the displacement of the gingival margin apically from the cemento-enamel junction and the exposure of root surface.

The aim of the study – to determine the prevalence and main clinical characteristics of gingival recession in patients with generalized periodontitis.

Materials and Methods. The participants in the study were 265 patients, 102 males and 163 females, from 20 to 68 years (mean age of 40.4±0.6 years). Clinical examination was performed using the Florida Probe System. The presence of a gingival recession and the recession depth in 6 sites near each tooth were investigated. Gingival recessions were systematized according to the classification proposed by Miller (1985).

Results and Discussion. Among 265 people, 9 patients with periodontal health (3.4 %) and 256 patients with generalized periodontitis of various degrees (96.6 %) were identified. The prevalence of gingival recession among all study participants was 90.2 %, and in patients with periodontitis – 90.6 %. Mean number of teeth examined per subject was 27.90±0.20 teeth. The mean number of teeth with a gingival recession per subject was 12.67±0.45 teeth or 45.8±1.6 %. The mean number of teeth with recession on the mandible (7.01±0.26) was significantly higher, than on the maxilla (5.72±0.25, p<0.005). The increase in the mean number of teeth with recession in the age group of 51–68 years is established in comparison with the age groups of 20–35 and 36–50 years (p<0.001). It has been established that smoking does not affect the development of gingival recession. On the maxilla, gingival recession occurs more often on the vestibular (cheek) surface of the teeth and in most cases is observed in the first molars and the first premolars. On the palatal surface of the teeth, the exposure of the palatal root of the first molar is most often determined. On the mandible, gingival recession in most patients was found on the vestibular surface of premolars and central incisors, on the lingual surface – on the central and lateral incisors. 56.9 % participants had generalized recession on the maxilla and 65.7 % – on the mandible. Only 27.2 % of people had the localized recession on both jaws. According to the Miller's classification, 49.8% participants had class I gingival recession (5.40±0.47 teeth), 2.1 % - class II (2.60±1.12 teeth), 90.8 % – class III (9.43±0.41 teeth) and 24.3 % – class IV recession (5.28±0.65 teeth), which are associated with generalized periodontitis Grade II–III.

Conclusions. The results of the high prevalence of gingival recession in patients with generalized periodontitis (90.2 %) indicate the need for early detection of risk factors, improvement of methods of complex diagnosis of periodontal phenotype and surgical treatment using modern methods of mucogingival surgery.