Recession Height Research Articles

Self-Rated Health among Unemployed Adults: the Role of Quiet Ego, Self-Compassion, and Post-Traumatic Growth

Unemployment can be associated with negative psychological and physical health outcomes when it undermines an individual’s sense of self-worth and confidence. This study examined whether quiet ego, a self-identity motivated by a compassionate stance toward the self and others would be positively associated with self-reported health. Further, we expected this relationship to be mediated by two types of psychological capital: self-compassion, the ability to show kindness and understanding to one’s self during times of disappointment, and post-traumatic growth (PTG), the ability to derive a sense of meaning from adverse experiences. We also expected self-compassion and PTG to be associated with a robust measure of self-rated health. We tested a double mediation model in a sample of adults recruited from an employment center at the height of the Great Recession in 2010 (N = 173) and were also able to make some limited comparisons with a sample of employed adults (N = 60). For unemployed adults, quiet ego was associated with PTG. Quiet ego was positively related to self-rated health, mediated by self-compassion, for unemployed and employed adults.

Does enamel matrix derivative application improve clinical outcomes after semilunar flap surgery? A randomized clinical trial.

To evaluate the treatment of gingival recessions by semilunar coronally positioned flap plus enamel matrix derivative (SCPF + EMD). Thirty patients with class I localized gingival recession were included. They were randomly allocated in two groups: SCPF + EMD and SCPF. Recession height (RH), recession width (RW), width of keratinized tissue (WKT), thickness of keratinized tissue (TKT), probing depth (PD), and clinical attachment level (CAL) were measured at baseline, 6 and 12months post-surgery. Patient/professional evaluation of esthetics and root sensitivity was performed. After 12months, mean root coverage was 1.98 ± 0.33mm for SCPF + EMD (90.86 ± 14.69%) and 1.85 ± 0.41mm (79.76 ± 17.44%) for SCPF (p > 0.05). The esthetic evaluation by the patient showed preference for SCPF + EMD. According to the professional evaluation (QCE), the use of EMD decreases the appearance of postoperative scar tissue line. There was a significant reduction in root hypersensitivity with no further complaints by the patients. The addition of EMD provides significantly better esthetics to SCPF, according to patient and professional assessments. SCPF + EMD is effective but not superior to SCPF for root coverage, after 12months. Previous clinical trials showed that the combination of EMD with coronally advanced flaps may enhance the outcome of root coverage. There is a lack of studies testing the combination of EMD with SCPF. The combination SCPF + EMD provides better esthetics when compared to the SCPF and is effective, but not superior, to SCPF for root coverage, after 12months. NCT02459704.

Laterally positioned flap along with acellular dermal matrix graft in the management of maxillary localized recessions.

The aim of this study was to evaluate acellular dermal matrix graft (ADM) combination with laterally positioned flap (LPF) and to compare the results with LPF alone in terms of root coverage, esthetics, and patient perspectives in gingival recessions. Twenty-two patients with localized Miller Class I/II recessions ≥ 3mm with gingival thickness (GT) < 0.8mm were included. Outcome parameters such as recession height and width, keratinized tissue (KT) height, GT, mean and complete defect coverage, patient satisfaction, and root coverage esthetic score (RES) were re-evaluated at 12months postoperatively. Mean and complete defect coverage were 94.80 and 72.73% in LPF+ADM group and 77.25 and 45.45% in LPF group, respectively. Significant differences were observed for KT and GT gain, patient satisfaction, and RES in favor of LPF group (p < 0.05). A significant positive correlation was established between GT and mean defect coverage (r = 0.448; p < 0.05). LPF is a successful approach in the treatment of localized Miller I/II gingival recessions. On the other hand, when thin donor tissue was thickened with an allogenic graft, more successful results regarding complete defect coverage, patient satisfaction, and RES were obtained. Increase in gingival thickness and keratinized tissue height represents critical improvements in the prognosis of the advanced localized recessions and will be beneficial for patient's periodontal health and esthetics. Both approaches can be used successfully as an alternative for soft tissue root coverage in specific localized cases with a limited amount of keratinized tissue apical to the defect.

Evaluation of the effect of EDTA on root coverage at free gingival graft procedure

Background: The present study has been designed to compare the effect of root surface biomodification with EDTA for the treatment of buccal gingival recession with free gingival graft.&#x0D; Materials and methods: This randomized controlled parallel clinical trial, 34 patients of 40 existing tooth Miller Class I and Class II gingival recession were treated with free gingival graft (FGG). Forty teeth with recession were assigned randomly to receive the free gingival graft with or without the application of an EDTA gel. Pre-treatment (Day 0) and post-treatment 3. and 6. months gingival recession height(GRH), gingival recession width(GRW), probing depth (PD), clinical attachment level(CAL) and width of keratinized tissue WKT were measured.&#x0D; Results: In FGG+EDTA group statistically significant changes from baseline were found GRH decreased from 4.7±1.5 mm to 1.3±1.2 and WKT increased from 0.9 ± 0.9 mm to 5.5±1.8 mm. Also in FGG group, GRH decreased from 4.6±1.3 mm to 1.3±1.2 mm and WKT increased from 0.9 ± 0.7 mm to 5.4±1.5 mm. For FGG and FGG+EDTA, the average root coverage 74.14% and 69.26% was found.&#x0D; Conclusion: In the light of these data obtained with the root surface biomodification agent EDTA have no beneficial effect for root coverage. In the light of these data obtained with the root surface biomodification agent EDTA have no beneficial effect for root coverage.&#x0D; Keywords: Gingival recession, free gingival graft, EDTA, root coverage

Treatment of gingival recession using a coronally-advanced flap procedure with or without placental membrane.

The aim of the present study was to compare the treatment of gingival recession defects using a coronally-advanced flap procedure with or without placental membrane. Sixty teeth in 15 patients with single and multiple Miller's class I and II gingival recession defects bilaterally in the anterior and premolar region of the maxilla and mandible were divided into two groups. In group I (control), 30 recession defects were treated with coronally-advanced flap alone using Zucchelli's technique. In group II (test), 30 recession defects were treated with coronally-advanced flap along with placental membrane. Probing depth, height of the gingival recession (HGR), clinical attachment level (CAL), width of the gingival recession, and width of the keratinized tissue (WKT) were recorded at baseline and 3 and 6months after the surgical procedures. There was a statistically-significant reduction in the HGR, gain in the CAL, and WKT in group II compared to group I. Coronally-advanced flap with placental allograft provides a reliable technique for root coverage when compared to coronally-advanced flap alone.

A Comparative Split Mouth Clinical Evaluation of Amniotic Membrane and Platelet Rich Fibrin in Patients with Gingival Recession: Two Case Reports

Gingival recession designates the oral exposure of root surface due to the displacement of gingival margin apical to cementoenamel junction. This is split mouth design study of two patients, the first of its kind, wherein patients having bilateral isolated recession were undertaken. Both the patients were treated using Coronally Advanced Flap (CAF) with Amniotic Membrane (AM) on left side and CAF with Platelet Rich Fibrin (PRF) on right side. Recession height, width of keratinized gingiva, Probing Pocket Depth (PPD) was recorded. Patient was recalled after 3 and 6 months. The clinical outcome of these surgical procedure accounted for complete recession coverage and increase in width of keratinized gingiva, with both CAF with AM and CAF with PRF. Furthermore, the results were stable even after six months.

Evaluation of acellular dermal matrix allograft [Alloderm®] with coronally positioned flap in the treatment of Miller's Class I or Class II gingival recession

Aim: The aim of the study was to clinically evaluate the efficacy of acellular dermal matrix allograft [Alloderm®] in combination with coronally positioned flap in treatment of Miller's Class I or Class II isolated gingival recessions. Materials and Methods: Fifteen systemically healthy patients with Miller's Class I or Class II isolated gingival recessions participated in the study. Coronally positioned flap was performed and acellular dermal matrix allograft [Alloderm®] was placed over the defect. Clinical parameters such as recession height, recession width, keratinized tissue height, clinical attachment level, probing depth, plaque index, and gingival index were evaluated at baseline, 3 months, and 6 months post surgery. The percentage of root coverage was calculated. Descriptive statistical analysis has been carried out using Student's t-test (two-tailed, dependent) to determine the significance of study parameters on continuous scale within each group. The Statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0, and R environment ver. 2.11.1 were used for data analysis. Results: In the study, the recession height decreased from the baseline of 2.50 ± 0.53 mm to 0.3 ± 0.48 mm at 3 months and remained unchanged after 6 months with percentage of reduction being 89%; recession width decreased from the baseline of 4.10 ± 0.74 mm to 0.7 ± 0.95 mm after 3 months and to 0.4 ± 0.52 mm after 6 months (91%), increase in the keratinized tissue height (KTH) from the baseline of 3.6 ± 0.70 mm to 4.7 ± 0.67 mm after 3 months and further increased to 6.4 ± 0.52 mm after 6 months (64%) and gain in CAL from baseline of 4 ± 0.82 mm to 1.9 ± 1.2 mm after 3 months and further reduced to 1.4 ± 0.52 mm after 6 months (74%). There was statistical difference in all the parameters indicating good percentage of root coverage. Conclusion: The use of Alloderm® along with coronally positioned flap provided significant improvement in all measured clinical parameters, indicating that graft gives favorable results in treating Miller's Class I or Class II isolated gingival recessions.

Comparison between coronally advanced flap technique and modified tunneling technique utilizing perforated acellular dermal matrix in treatment of multiple gingival recessions

Objective: The aim of the present study was to evaluate the root coverage outcomes treated by modified tunneling technique (MTT) and compare it to coronally advanced flap (CAF) technique utilizing perforated acellular dermal matrix (PADM). Subjects and Methods: Twenty patients with 40 gingival recession (GR) sites of Miller class I and class II were selected to participate in this study. Sites treated by MTT were assigned as group I while sites treated by CAF were assigned as group II. PADM was incorporated in both groups. Patient satisfaction test, root coverage esthetic score (RES) system and periodontal chart including recession height (RH), recession width (RW), width of keratinized tissue (KW), Thickness of the keratinized tissue (TKT) were used in the clinical evaluation. Results: MTT showed superior results in relation to patient satisfaction test and RES. CAF showed higher root coverage percentage (94±0.0) than MTT (89.5 ±9.30) without statistically significant difference among them. Conclusion: MTT is considered a good treatment modality for GR, it meets patients demands and gives clinical acceptable results.

Nanofilled and conventional resin-modified glass ionomer fillings combined with connective tissue grafts for treatment of gingival recessions with non-carious cervical lesions.

The aim of this study was to evaluate the clinical root coverage results of subepithelial connective tissue grafts (SCTG) performed on teeth with gingival recessions and non-carious cervical lesions (NCCLs) that were restored with cervical fillings and compare the results of two different filling materials: resin-modified glass ionomer (RMGIC) and nano-ionomer cements (NIC). A total of 54 teeth with Miller Class I gingival recessions with or without NCCLs in 36 patients (28 females, 8 males) were treated with SCTGs. Cervical lesions were randomly treated with RMGIC or NIC restorations. Periodontal clinical parameters, height of gingival recession (HGR), width of gingival recession (WGR), height of keratinized tissue, and dentin sensitivity were measured at baseline and 3, 6, and 12 months postoperatively. HGR and WGR values were statistically significantly reduced at all time points when compared to baseline values in all groups. There were no statistically significant differences between the groups in any clinical periodontal parameter (P > 0.05). The percentage of root coverage at 12 months was 89.5%, 90.1%, and 96.2% in the RMGIC, NIC, and control groups, respectively. Successful root coverage with connective tissue grafts may be achieved on teeth restored with RMGIC or NIC cervical fillings.

Clinical evaluation of combined surgical/ restorative treatment of gingival recession-type defects using different restorative materials: A randomized clinical trial

Background/purposeAn ideal therapeutic procedure for the treatment of gingival recession associated with an NCCL has presented a challenge to clinicians. Various dental materials and surgical approaches have been used to manage gingival recessions associated with NCCLs for the most predictable combined surgical/restorative treatment. The objective of this study was to evaluate the treatment of gingival recessions associated with non-carious cervical lesions (NCCL) using a modified coronally advanced flap (MCAF) in combination with a connective tissue graft (CTG) on restored root surfaces. Materials and methodsTwenty-three systemically healthy subjects, who were positive for the presence of three cervical lesions associated with gingival recessions in three different adjacent teeth, were enrolled in the study. The NCCL were each restored prior to surgery by using one of three different materials: nanofilled composite resin (NCR), resin-modified glass ionomer cement (RMGI) or giomer. The gingival recession defects were treated by CTG. ResultsInter-group differences were not statistically significant for probing depth (PD), relative recession height (rRH), relative clinical attachment level (rCAL), keratinized tissue width (KTW) or keratinized tissue thickness (KTT) (p > 0.05) among the groups at any time. The mean percentage of defect coverage was 71.18 ± 23.16% for NCR + CTG group; 71.33 ± 22.33% for RMGI + CTG group; and 64.23 ± 20.33% for giomer + CTG group at 1 year postoperatively (p > 0.05). ConclusionThe combined surgical/restorative treatments provided successful clinical results. Giomer + CTG may be less effective compared to other groups for treatment of gingival recession associated with NCCL.

Xenogenous Collagen Matrix and/or Enamel Matrix Derivative for Treatment of Localized Gingival Recessions: A Randomized Clinical Trial. Part I: Clinical Outcomes.

Considering xenogeneic collagen matrix (CM) and enamel matrix derivative (EMD) characteristics, it is suggested that their combination could promote superior clinical outcomes in root coverage procedures. Thus, the aim of this parallel, double-masked, dual-center, randomized clinical trial is to evaluate clinical outcomes after treatment of localized gingival recession (GR) by a coronally advanced flap (CAF) combined with CM and/or EMD. Sixty-eight patients presenting one Miller Class I or II GRs were randomly assigned to receive either CAF (n = 17); CAF + CM (n = 17); CAF + EMD (n = 17), or CAF + CM + EMD (n = 17). Recession height, probing depth, clinical attachment level, and keratinized tissue width and thickness were measured at baseline and 90 days and 6 months after surgery. The obtained root coverage was 68.04% ± 24.11% for CAF; 87.20% ± 15.01% for CAF + CM; 88.77% ± 20.66% for CAF + EMD; and 91.59% ± 11.08% for CAF + CM + EMD after 6 months. Groups that received biomaterials showed greater values (P <0.05). Complete root coverage (CRC) for CAF + EMD was 70.59%, significantly superior to CAF alone (23.53%); CAF + CM (52.94%), and CAF + CM + EMD (51.47%) (P <0.05). Keratinized tissue thickness gain was significant only in CM-treated groups (P <0.05). The three approaches are superior to CAF alone for root coverage. EMD provides highest levels of CRC; however, the addition of CM increases gingival thickness. The combination approach does not seem justified.

Clinical evaluation of coronally advanced flap with or without platelet-rich fibrin for the treatment of multiple gingival recessions.

The aim of this randomized, controlled study was to assess the clinical effect of platelet-rich fibrin (PRF) in combination with coronally advanced flap (CAF) on root coverage, esthetics, and patient satisfaction when compared to CAF alone for the treatment of multiple Miller class I recessions. A total of 24 patients with 52 Miller class I multiple recessions ≥3mm were included and divided into CAF + PRF and CAF groups. At baseline and 12months after surgery, recession height (RH), keratinized tissue height, gingival thickness (GT), and mean and complete defect coverage were evaluated. Patient satisfaction and root coverage esthetic scores were also assessed. Baseline RH in CAF + PRF and CAF groups was 3.15±0.24 and 3.36±0.34mm, respectively. Intragroup comparisons revealed significant differences at 12months for all parameters (p<0.05). RH reduction was 2.75±0.33 and 2.51±0.33mm (mean root coverage of 88.36 and 74.63%) in the CAF + PRF and CAF groups, respectively. Intergroup differences were found to be significant for GT gain (p<0.05). The additional use of PRF membrane did not provide additional benefits in terms of root coverage outcomes compared with CAF alone. The use of PRF membranes increased tissue thickness significantly.

Economic diversity, unemployment and the Great Recession

Abstract We revisit the relationship between economic diversity and unemployment in light of the economic shock of the Great Recession. Using U.S. county data we test the overall effect of increased industrial diversity on county level unemployment. Allowing for structured spatial spillovers across counties we find evidence supporting the notion that economic diversity within a given county is associated with lower levels of unemployment across all years of this analysis (2007–2014), while the diversity of neighboring counties was only associated with decreased unemployment at the height of the Great Recession. This spatial spillover effect was responsible for turning the overall marginal effect of diversity on unemployment significant for the period representing the height of the Great Recession and the early recovery period (2009–2011). These results suggest that it is the economic diversity of one’s neighbors that provides an unemployment buffer in times of economic downturns. This spatial spillover effect represents a novel finding and it is hypothesized that diversity of one’s neighbors plays an important role in assisting in the search for employment in response to an economic shock.

Comparative Evaluation of Coronally Advanced Flap with Platelet-rich Fibrin vs Amniotic Membrane for the Treatment of Gingival Recession

ABSTRACT Background The purpose of this clinical trial was to compare the outcome of gingival recession technique using the coronally advanced flap (CAF) with platelet-rich fibrin (PRF) and amniotic membrane. Materials and methods About 15 patients with bilateral Miller class I buccal gingival recessions (4–5 mm) in maxillary and mandibular canines were selected. The recessions were randomly assigned to receive either the CAF with PRF or the CAF with amniotic membrane. Recession height (RH), recession width (RW), width of keratinized tissue (WKT), thickness of keratinized tissue (TKT), probing depth (PD), and clinical attachment level (CAL) were measured at baseline as well as 6 months postsurgery. Patient satisfaction with esthetics, root sensitivity, and postoperative pain was also evaluated. Results The average percentages of root coverage for CAF with PRF and CAF with amniotic membrane were 92.95% and 97.40% (p &lt; 0.05) respectively, and the complete root coverage observed was 56.94% and 76.47% respectively. The CAF with amniotic membrane showed a statistically significant increase in TKT (p &lt; 0.05). There were no significant differences between the two groups with regard to RH, RW, WKT, PD, and CAL. The esthetic condition after both treatments was considered satisfactory by the patients. Conclusion The outcome of this study reflects that CAF with PRF and amniotic membrane can be successfully used to treat class I gingival recession. How to cite this article Gautam A. Comparative Evaluation of Coronally Advanced Flap with Platelet-rich Fibrin vs Amniotic Membrane for the Treatment of Gingival Recession. J Health Sci Res 2017;8(1):31-37.

Comparative Evaluation of Platelet-Rich Fibrin with Connective Tissue Grafts in the Treatment of Miller's Class I Gingival Recessions.

Background:One of the most common aesthetic problem encountered in the field of periodontology is gingival recession, which is, perceived by the patients as increase in length of teeth. The treatment of buccal gingival recession is a common requirement due to aesthetic concern or root sensitivity. This study was planned to evaluate the efficacy of PRF membrane compared to that of CTG in Miller's class I gingival recessions.Materials and Methods:32 sites with Miller's Class I gingival recessions, out of which 16 sites received PRF (test) and 16 sites received CTG (control). Each patient had undergone an initial periodontal treatment, including oral hygiene instructions, plaque control, and scaling and root planing, followed by re-evaluation. All clinical recordings; recession height, recession width, clinical attachment level, height of keratinized tissue, thickness of keratinized tissue, healing index and pain perception, were performed immediately before surgery (baseline) and after 6 months interval following periodontal surgery.Results:In the test group, significant improvement was seen in terms CAL, REC-HT, REC-WD, HKT and TKT from baseline to 6 months. In the control group, only significant improvement seen was in REC-HT and TKT from baseline to 6 months. Comparison of both Healing Index and VAS score was done and it showed no significant difference between test and the control group except VAS at 1 week.Conclusion:Though CTG is a gold standard procedure, PRF can be used as an alternative procedure by keeping patient's comfort and recognition in mind.

Playing the Odds: The Realities of State-By-State Suitability Determinations and the Need for Federal Regulation

With some exceptions, gaming in the United States is a growth industry. While commercial casino revenue peaked in 2007, followed by a sharp decline at the height of the Great Recession, in 2012 national gaming revenues reached the second highest level in history. Not only has the rebound translated into increased revenues, employment rates, and economic development, it has also led to sharp increases in gaming tax revenue for the vast majority of states that permit commercial casinos – most notably in Kansas, Maryland, Maine, and New York. While gaming heavily impacts interstate commerce, the industry is still governed by a patchwork of inconsistently applied state laws. These inconsistencies are especially prevalent in state-by-state suitability determinations in which state regulators may disagree about the suitability of a single casino applicant or otherwise make conflicting determinations of similarly situated applicants. These inconsistencies, coupled with the lack of meaningful judicial review, have caused uncertainty for would-be applicants and necessitates meaningful federal reform.

Did the Great Recession Downsize Immigrants and Native-Born Americans Differently? Unemployment Differentials by Nativity, Race and Gender from 2007 to 2013 in the U.S.

We use data from the Current Population Survey from 2007 and 2013 to investigate demographic differentials in unemployment during the Great Recession in the U.S. Although our analysis is primarily exploratory and descriptive, our major research objective is to illuminate the unemployment differential between the foreign born and the native born. The findings indicate that during the height of the Great Recession, the foreign born had higher unemployment rates than the native born. However, this differential is statistically explained by their observed characteristics, such as race/ethnicity, gender, age and education. With the net of those variables and a few other demographic covariates, foreign born workers as an overall group actually had somewhat lower chances of being unemployed than native born workers. This finding is discussed in terms of the selectivity of immigrant workers and the possibility that they are somewhat more immediately dependent on having a job. After breaking down the foreign born into major racial/ethnic groups, the results suggest that foreign-born blacks and foreign-born Hispanics are particularly selective with the net of their observed characteristics. The possible sources of such differentials by race/ethnicity and by gender are discussed.

Medication Costs and Adherence of Treatment Before and After the Affordable Care Act: 1999–2015

To examine national changes in rates of cost-related prescription nonadherence (CRN) by age group, we used data from the 1999-2015 Sample Adult and Sample Child National Health Interview Surveys (n = 768 781). In a logistic regression analysis of 2015 data, we identified subgroups at risk for cost-related nonadherence. The proportion of all Americans who did not fill a prescription in the previous 12 months because they could not afford it grew from 1999 to 2009, peaking at 8.3% at the height of the Great Recession and dropping to 5.2% by 2015. CRN among seniors, however, peaked in 2004 at 5.4% and dropped to 3.6% after implementation of Medicare Part D in 2006. CRN is responsive to improved access related to implementation of Medicare Part D and the Affordable Care Act.

Root Coverage in Smokers with Acellular Dermal Matrix Graft and Enamel Matrix Derivative: A 12-Month Randomized Clinical Trial.

This study investigated whether enamel matrix derivative (EMD) contributes to root coverage of gingival recessions performed with acellular dermal matrix graft (ADMG) in smokers during a 12-month follow-up. A sample of 19 smokers presenting bilateral Miller Class I or II gingival recessions were included. Selected sites randomly received both ADMG and EMD (test) or ADMG alone (control). Probing depth, clinical attachment level, gingival recession height, keratinized tissue, and root coverage were evaluated. Mean gain in recession height (P < .05), sites with complete root coverage (P < .05), and percentage of root coverage (59.7% and 52.8%, respectively) favored the test group compared with the control group.

Does the Papilla Preservation Flap Technique Induce Soft Tissue Modifications over Time in Endodontic Surgery Procedures?

IntroductionThe aim of the present controlled clinical trial was to compare 2 incision techniques, papilla base incision (PBI) and sulcular incision (IS), evaluating changes in papilla and recession height over a 12-month period. MethodsA total of 24 subjects requiring endodontic surgery on a single tooth were enrolled. PBI was used in 1 group and IS in the other group. The primary outcomes were changes in gingival recession of the tooth affected by periapical lesions and the mesial and distal teeth and the mesial and distal papilla height using the treated tooth as the reference. Outcome variables were assessed at baseline and 12 months after the surgical intervention. Statistical analysis was performed by a blinded operator through appropriate tests, with significance set at a P value equal to .05. ResultsIn the PBI group, the papilla height at the 12-month follow-up in the mesial and distal aspect decreased 0.10 ± 0.32 mm and 0.10 ± 0.32 mm, respectively, and 0.23 ± 0.68 mm and 0.25 ± 0.40 mm, respectively, in the IS group without any significant differences. There were no differences found for recession change values between groups. ConclusionsThe PBI and IS approaches in endodontic surgery showed similar results in terms of papilla height preservation and recession changes.