THE INFLUENCE OF THE AGE ON THE PREVALENCE OF GINGIVAL RECESSION IN PATIENTS WITH PERIODONTITIS

Abstract

Gingival recession is a common clinical condition in the dental practice, which is characterized by the root surface exposure due to the apical displacement of the marginal gingival tissues. Since the teeth' root surfaces become open to the environment of the oral cavity, the consequences of gingival recession are a disturbance of aesthetics (mainly when they occur in the frontal area), the development of hypersensitivity root caries, and non-carious cervical lesions. Despite the numerous studies carried out, the exact mechanism of the development of gingival recession is not fully understood, and it is generally accepted that it has a multifactorial etiology. Gingival recession can occur directly due to an infectious and inflammatory process in the periodontal tissues, anatomical features, as a result of the effect of mechanical or iatrogenic factors on soft tissues, or their action in combination with each other. The prevalence of gingival recessions worldwide varies from 22 to 100% and mainly depends on age, the size of the studied population, diagnostic criteria, and statistical data processing methods. 
 The aim was to determine the influence of age on the prevalence of gingival recession in patients with periodontitis. 
 Materials and methods. One hundred thirty-three patients with periodontitis aged 29 to 59 years were included in the study and divided into four groups according to their age: 20–29 years, 30–39 years, 40–49 years, 50–59 years. Inclusion criteria were the presence of periodontitis, age over 20 years, and the presence of more than 20 teeth in the oral cavity. 
 Participants were interviewed about demographic data, smoking status, and oral hygiene skills. All patients underwent a clinical examination using the clinical and instrumental program Florida Probe system. Gingival recession was recorded in the presence of root surface exposure of 1 mm or more. According to the size of the exposed surfaces of the tooth roots, three degrees of severity of gingival recession were assessed: mild gingival recession (less than 3 mm), moderate gingival recession (3 to 4 mm), severe gingival recession (5 mm or more). The severity of gingival recession was estimated in mm as the distance between the cemento-enamel junction and the gingival margin. Subsequently, the gingival recession was classified using the Miller recession classification [7].
 Results of the studies and their discussion. The study results showed that a high prevalence of gingival recession was found in patients with periodontitis in the Ukrainian population. Exposure of the surface of the teeth' roots by 1 mm or more was present in around 2233 teeth, which corresponds to 65.86 (61.4-70.3)% of all examined teeth. The average number of teeth with the gingival recession increases with age: in those aged 20-29, the gingival recession was present in 42,86% of the teeth, in patients 30-39 years of age, the gingival recession was present in around 59,59% of the teeth, in patients 40-49 years of age the gingival recession was present in around 70,49% of the teeth, in those, older than 50 years, the gingival recession was present in around 82.72% of the teeth. Incisors and first molars were the most affected teeth by the gingival recession. In patients with periodontitis, the gingival recession of mild degree (up to 3 mm) was determined around 44.01 (40.8-47.2) % of teeth, the gingival recession of moderate degree (from 3 to 4 mm) – around 17.41 (14.3-20.5) % of teeth, the gingival recession of severe degree (5 mm or more) – around 4.42 (2.7-6.2)% of teeth. The severity of recession in patients of different age groups was determined: the gingival recession's severity increases with age. The average severity of gingival recession (the length from the cemento-enamel junction to the gingival margin) was determined in patients of different age groups: in the group of 20 years old, it was 0.28 ± 0.28 (M ± SD) mm, in the group of 30 years old – 0.43 ± 0.37 (M±SD) mm, in the group of 40 years old – 0.78 ± 0.70 (M ± SD) mm, in the group of 50 years old – 1.20 ± 0.70 (M±SD) mm. According to the Millers classification, Class III of the gingival recession was more common in age groups I and II, Class IV of gingival recession, which have an unfavourable prognosis of treatment, were more often manifested in older patients age groups.