ANALYSIS OF THE GINGIVAL RECESSION PREVALENCE AMONG DENTAL PATIENTS CONSIDERING ASSOCIATED AGE-RELATED, IATROGENIC AND PATHOLOGICAL CHANGES OF DENTAL STATUS

Abstract

Assessment of gingival recessions prevalence and explicitation of their distribution among studied samples of dental patients considering criteria of age, sex, severity of gingival apical migration and the facts of associated dental status changes can potentially help to identify specific risk groups. Implementation of preventive measure among such risk groups could potentially optimize the prognosis of future conservative or surgical treatment of gingival recessions.
 The objective of present study was to evaluate the prevalence of gingival recessions among dental patients, while also considering the associated age-related, iatrogenic and pathological changes of dental status. In order to assess the prevalence of gingival recessions among dental patients a study sample was formed out of the patients of the private dental clinic "Dentistry 3D Plus" (Cherkasy).
 Formation of study sample was provided by the method of block randomization according to the different age subgroups (18-19 years, 20-29 years, 3039 years, 40-49 years and 50-59 years). Each subgroup was set with 100 dental patients of the appropriate age. The diagnosis of recession was established due to the specific diagnostic criterion of marginal gingiva apical migration with exposure of the tooth root surface. The recession classification was performed according to the approach proposed by P.D. Miller’s. The depth of the recession was determined using a periodontal probe of CP 15 North Carolina design. Recessions were identified in 52 persons (52,0%) among 100 patients aged 18-19 years, in 68 persons (68,0%) among patients aged 20-29 years, in 95 persons (95,0%) among patients aged 30-39 years, in 96 persons (96,0%) among patients aged 40-49 years, and in 96 persons (96,0%) among patients aged 50-59 years. In general, the average prevalence of Miller’s class I recessions among all pathologies diagnosed within different age subgroups was 61,45±16,82%, prevalence of Miller’s class II recession reached 10,74±3,56%, prevalence of Miller’s class III recession was 21,71±10.80%, and prevalence of Miller’s class IV recession was 6,10±2.97%. Thus, Miller's class I and III recessions were the most prevalent, and the frequency of their diagnostics was statistically higher than class II (p < 0,05) and class IV recessions (p < 0,05). The average depth of recessions that met the diagnostic criteria for class I according to Miller was 2,31±1.35 mm, for Miller’s class II – 4,27±2,40 mm, for Miller’s class III – 6.31 ± 2.86 mm, for Miller’s class IV – 7,53±2,29 mm. Among all diagnosed recessions cases that were observed among patients of different age subgroups, 13,71±6,72% were associated with periodontitis pathology, 5,04±2,98% with overcrowding, 7,80±3,84% with signs of pathological attrition, 9,06±2,13% with non-carious cervical dental lesions, 7,85±1,60% with carious lesions of enamel and dentin, 7,97±1,83% with parafunctional activity and/or traumatic occlusion pattern, 7,85±4,26% with the fact of orthodontic intervention, 9,75±2,44% with existing problematic restorations, 8,16±1.62% with anomalies of teeth position, 7,72±0,74% with inadequate oral hygiene condition, 5,25±0,90% with bad habits that were identified during anamnesis collection, 5,28±2,60% with anomalies of mucous bundles attachment, while in 4,55±4,18% of the cases diagnosed recessions were not clinically associated with functional or structural dental status disorders.
 The results of study demonstrated a progressive increase in the number of recessions associated with periodontal disease (p < 0,05), pathological attrition (p < 0,05), non-carious dental lesions (p <0.05) and problematic restorations (p < 0,05 ) related to the parallel increase of patients’ average age, which according to the provided regression analysis was statistically significant during the comparison of such studied parameters among different age subgroups. Patients aged 30 years and older, male, and those with clinical signs of periodontitis, pathological attrition, non-carious and carious cervical lesions, poor oral hygiene, overcrowding of teeth, abnormalities of teeth position and abnormal attachment of mucous membranes could be categorized as those having potential risk for further recession development. Therefore, such patients require provision of timely comprehensive dental treatment to maintain the level of soft tissue coverage in the area of their own teeth and to correct changes in dental status associated with gingival recession development. Considering established relationship between the frequency of recession diagnostics among patients of different age subgroups and associated age-related, iatrogenic and pathological changes of dental status, it is advisable to determine how the latter may affect the prognosis of surgical treatment of gingival recessions with the use of flap displacement techniques and different soft tissue transplants for restoring soft tissue coverage of exposed root surfaces.