Gingival recession: Narrow perception - erroneous; wider canvass - out-of-focus!
Journal name: Journal of Indian Society of Periodontology
Original article title: Gingival recession: Narrow perception - erroneous; wider canvass - out-of-focus!
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Ashish Kumar
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Gingival recession: Narrow perception - erroneous; wider canvass - out-of-focus!
Year: 2023 | Doi: 10.4103/jisp.jisp_118
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Gingival recession, a common condition in individuals with periodontal diseases, results in the exposure of the root surface. Epidemiological studies have shown a strong association between gingival recession and age, particularly after 45 years, where periodontitis leads to significant loss of periodontal tissues. This condition is not only prevalent but also has been observed to vary according to region and age demographic, as shown in data from the United States and Germany. While pocket depth is a primary factor in clinical attachment loss (CAL) for younger individuals, gingival recession becomes the major contributor in older adults, emphasizing the need for a broader understanding and approach to its treatment.
The Complexity of Gingival Recession
One critical observation in the management of gingival recession revolves around the limitations of existing classification systems. The 2017 classification describes gingival recession as an apical shift in the gingival margin associated with CAL but has notable limitations. It primarily addresses labial and buccal surfaces, neglecting recession on other surfaces, such as lingual or interproximal areas. This oversight could misrepresent the actual status of a patient's periodontal health and may hinder appropriate diagnosis, prognosis, and treatment planning. Furthermore, the reliance on factors like the detectability of the cementoenamel junction (CEJ) complicates classification, particularly in cases where CEJ visibility is compromised due to non-carious lesions. These issues underscore the necessity for a more inclusive and practical classification that accurately reflects the pathological conditions encountered in clinical practice.
Conclusion
The rising prominence of gingival recession in aging populations necessitates a reevaluation of treatment strategies that extend beyond cosmetic concerns, directing attention to non-aesthetic areas and the implications of periodontal disease. Current paradigms of periodontal therapy largely focus on pocket depth reduction, which overlooks the substantial impact of gingival recession on patient quality of life. Emphasizing comprehensive management of all gingival recessions—irrespective of aesthetic significance—could pave the way for improved treatment outcomes and economic opportunities within periodontal therapy. Addressing these gaps in classification and treatment will ultimately enhance patient care and acknowledge the multifaceted nature of gingival recession.
FAQ section (important questions/answers):
What is gingival recession and its common causes?
Gingival recession is the exposure of the root surface due to the apical shift of the gingival margin. Common causes include periodontal diseases like periodontitis and aggressive oral hygiene practices, which may lead to attachment loss and root exposure.
How does age affect the prevalence of gingival recession?
Epidemiological studies show that gingival recession associates with increasing age. After 45 years, most periodontal tissue loss manifests as recession rather than pocket depth, indicating that older adults are more widely affected by this condition.
What are the limitations of the new gingival recession classification?
The 2017 classification primarily recognizes recessions on labial/buccal surfaces, disregarding those on other tooth surfaces. This limitation can hinder accurate diagnosis, treatment planning, and does not encompass the full range of recession types.
Why is treatment for gingival recession often limited to anterior regions?
Treatment tends to focus on aesthetic concerns, which are more prevalent in the anterior regions. However, many gingival recessions occur in non-aesthetic areas, warranting broader therapeutic approaches that address all regions of the mouth.
What role do periodontal diseases play in gingival recession?
Periodontal diseases, specifically periodontitis, are major contributors to gingival recession. They not only cause clinical attachment loss but also present challenges in achieving effective treatment due to associated interproximal attachment loss.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Gingival recession: Narrow perception - erroneous; wider canvass - out-of-focus!”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Surface:
The term 'Surface' in the context of gingival recession and periodontal disease refers to the area of the tooth and surrounding gingival tissues affected by recessions. It highlights the importance of understanding recession across various tooth surfaces—buccal, lingual, and interproximal—for accurate diagnosis and effective treatment planning, beyond solely aesthetic considerations.
2) Disease:
'Disease' is pivotal in understanding gingival recession as it primarily arises from periodontal diseases like periodontitis. The focus on disease emphasizes the underlying pathologies contributing to recession, linking tissue loss to clinical conditions that require comprehensive evaluation by dental professionals. Effective management necessitates addressing the disease process rather than just aesthetic outcomes.
3) Observation:
'Observation' involves the careful assessment of gingival conditions, such as recession patterns, depth, and associated clinical attachment loss. Through observational studies, dental researchers can identify trends and correlations, like the impact of aging on recession prevalence. Observational data is crucial for developing treatment strategies and understanding the epidemiology of periodontal conditions.
4) Hygiene (Hygienic):
'Hygiene' emphasizes the role of oral health practices in the prevention and progression of gingival recession. Poor oral hygiene is linked to the onset of periodontal diseases, which can exacerbate recession. Maintaining good oral hygiene is essential for preserving gingival health, preventing further recession, and enhancing overall periodontal treatment outcomes.
5) Reason:
'Reason' signifies the underlying factors contributing to gingival recession, including aggressive oral hygiene practices or periodontal disease. Understanding these reasons aids practitioners in addressing root causes rather than merely treating symptoms. It prompts a broader perspective on patient management by incorporating preventive measures to mitigate recession risks and improve periodontal health.
6) Study (Studying):
'Study' refers to research efforts analyzing the epidemiology and treatment of gingival recession. Studies like NHANES and SHIP provide valuable data regarding the prevalence and risk factors associated with recession across various populations. The findings from such studies inform clinical guidelines and highlight the need for comprehensive approaches to periodontal care.
7) Inflammation:
'Inflammation' is a key component in the discussion of periodontal disease and gingival recession. Chronic inflammation results from bacterial plaque accumulation and contributes to periodontal tissue destruction. Understanding the role of inflammation in disease progression is vital for effective management, influencing treatment decisions aimed at reducing inflammation and restoring periodontal health.
8) Measurement:
'Measurement' highlights the importance of quantifying clinical parameters, such as clinical attachment loss (CAL) and probing depth, in diagnosing and managing gingival recession. Accurate measurement is essential for assessing the severity of recession, planning treatment strategies, and evaluating the effectiveness of periodontal interventions over time.
9) Reliability:
'Reliability' stresses the need for dependable clinical classifications and evaluation methods in diagnosing gingival recession. High reliability ensures that clinical findings, such as recession types and depths, can be consistently reproduced among practitioners, enhancing communication and treatment planning. Reliable assessments lead to better patient outcomes and informed therapeutic approaches.
10) Bleeding:
'Bleeding' often indicates active periodontal disease and is a crucial clinical sign observed during dental examinations. The presence of bleeding on probing can signal gingival inflammation and reiterates the importance of assessing periodontal health in conjunction with gingival recession. Monitoring bleeding informs treatment decisions and highlights the need for improved oral hygiene.
11) Channel:
'Channel' can refer to new avenues of inquiry or therapeutic options in managing gingival recession. Exploring potential channels beyond aesthetic regions may allow practitioners to address recession effectively in non-aesthetic areas, ultimately broadening the economic viability of periodontal therapies and improving patient care across a wider demographic.
12) Doubt:
'Doubt' represents the uncertainties and complexities surrounding the treatment of gingival recession, particularly regarding prognosis based on classification systems. The presence of doubt can stem from the inadequacy of current classifications to address variations in recession types, demonstrating the need for a more inclusive framework that considers all factors affecting periodontal treatment outcomes.
13) Ship:
'Ship' refers to the 'Study of Health in Pomerania,' a significant epidemiological study investigating various health parameters, including periodontal conditions. The findings from such studies contribute vital data on the prevalence of gingival recession, ultimately influencing clinical guidelines and our understanding of the public health impact of periodontal diseases.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Gingival recession: Narrow perception - erroneous; wider canvass - out-of-focus!’. Further sources in the context of Science might help you critically compare this page with similair documents:
Periodontal disease, Gingival Recession, Periodontal Plastic Surgical Procedure, Dentin hypersensitivity, Clinical attachment loss, Pocket depth, Aesthetic dentistry.