The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study

Abstract

Conflict of interest:The authors certify that there is no conflict of interest concerning the contents of the study. This study has been self-supported by the authors.Key words: gingival recession, diagnosis, periodontal disease, classification, aesthetics, clinical attachment level, root coverage. Running title: Interproximal CAL for gingival recessions Clinical relevance Scientific rationale for the studyNo information concerning the reliability of classifications of gingival recessions is currently available and there is no general consensus on the use of a specific system. In addition, the prediction of the gingival margin position following root coverage is a controversial issue. Principal findingsUsing the level of interproximal clinical attachment as identification criterion the proposed classification of gingival recessions showed an ICC= 0.86 (almost perfect agreement) among different examiners. Furthermore, the proposed classification was predictive of the final root coverage outcomes at the 6-month follow-up. Practical implicationsA classification system of gingival recessions based on the interproximal CAL may aid clinicians for a reliable categorization of defects and an effective prediction of treatment outcomes.

Root Coverage with Coronally Advanced Flap with Connective Tissue Graft: Literature Review and Case Report

“…El mejor resultado en cuanto al aumento en grosor de encía insertada o tejido queratinizado se da cuando se utiliza el procedimiento de colgajo de avance coronal más injerto de tejido conectivo (3,10,12). En cuanto a cobertura radicular y mejores resultados estéticos, la técnica de colgajo desplazado hacia coronal ha sido la más aceptada, sin embargo, la necesidad de poseer tejido queratinizado en la zona apical al defecto ha sido una limitante.…”

“…La pérdida de inserción en la zona interproximal fue menor o igual a la pérdida de inserción bucal. Esta pérdida de inserción en zonas interproximales se relaciona con una pérdida ósea horizontal (3). Recesión tipo 3 o RT3: Recesión gingival con pérdida de inserción gingival en zonas interproximales.…”

Reliability study of Mahajan′s classification of gingival recession: A pioneer clinical study

“…After these classifications, some other modification were also given by authors like Mahajan and Pini-prato et al [24] P. Prato classified gingival recessions into four classes based on presence and absence of CEJ and surface discrepancy. Recently, Cairo et al [14] have also proposed and tested the reliability of a classification system for GRD.…”

“…Until recently, Miller's classification system was considered as the best classification system for classifying GRD, but with the advancements in diagnosis and treatment of gingival recessions drawbacks of Miller's system have been pointed out by some researchers. [13141516] Therefore, in the absence of a quality classification system to classify GRD, the need for a updated classification system is immense, hence the present system for classifying GRD is proposed after testing it on 175 clinical sites. The results of our classification system were evaluated and vis-a-vis compared with the popular Miller's classification system based on the criteria given by Murphy[25] in 1997, who suggested that a classification system must have the following characteristics.…”

“…The importance of developing new improved classification system lies in the fact that recent studies have pointed out some inherent limitations and drawbacks in the already popular classification systems. [13141516] Although most of the clinicians are aware about the clinical implications of GRD, but until date there is no consensus on the various classifications used to classify GRD therefore, considering all these aspects, the present study was carried out to test the reliability of a new classification system for classifying GRD evolved from the popular Miller's classification system.…”