Non-surgical treatment options for gingival recession: a dermatologic perspective
DOI:
https://doi.org/10.25251/g649ga91Keywords:
dermatology, gingiva, gingival recession, multidisciplinary care, periodontal recessionAbstract
Gingival recession is characterized by exposure of the tooth root owing to displacement of the gingival margin. Although commonly managed by dentists and periodontists, recognition of gingival recession could be expanded to other specialists, including dermatologists. Dermatologists are important because gingival health can be negatively impacted in several dermatologic diseases, such as pemphigus vulgaris and oral lichen planus. This review aims to expand the understanding of treatment options for gingival recession, highlighting their relevance not only to dentists and periodontists, but also to dermatologists, who are uniquely positioned to contribute to multidisciplinary care. The review focuses on non-surgical treatment options, as these are most relevant to dermatologists. Non-surgical management largely involves addressing the underlying etiology, treating symptoms, and improving aesthetics. Dermatologists may contribute to multidisciplinary care by educating patients on aspects of non-surgical management, including improving oral hygiene and treating hypersensitivity.
References
1. Imber JC, Kasaj A. Treatment of Gingival Recession: When and How? Int Dent J. 2021;71:178-87. [PMID: 34024328].
2. Kassab MM, Cohen RE. The etiology and prevalence of gingival recession. J Am Dent Assoc. 2003;134:220-5. [PMID: 12636127].
3. Vignoletti F, Di Martino M, Clementini M, et al. Prevalence and risk indicators of gingival recessions in an Italian school of dentistry and dental hygiene: a cross-sectional study. Clin Oral Investig. 2020;24:991-1000. [PMID: 31278617].
4. Seong J, Bartlett D, Newcombe RG, et al. Prevalence of gingival recession and study of associated related factors in young UK adults. J Dent. 2018;76:58-67. [PMID: 29933005].
5. Patel M, Nixon PJ, Chan MF. Gingival recession: Part 1. Aetiology and non-surgical management. Br Dent J. 2011;211:251-4. [PMID: 21941318].
6. American Academy of Periodontology. Glossary of Periodontal Terms. Chicago: American Academy of Periodontology. https://members.perio.org/libraries/glossary?ssopc=. Accessed on September 28, 2024.
7. American Dental Association. CDT 2024: Current Dental Terminology. Chicago: American Dental Association; 2023. https://www.ada.org/publications/cdt/glossary-dental-terms. Access on September 28, 2024.
8. Jose M, Arya S, G T F. Oro-dental regeneration. 2022. p. 53-76.
9. Grover V, Kumar A, Jain A, et al. ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity. J Indian Soc Periodontol. 2022;26:307-33. [PMID: 35959314].
10. Patano A, Malcangi G, De Santis M, et al. Conservative Treatment of Dental Non-Carious Cervical Lesions: A Scoping Review. Biomedicines. 2023;11. [PMID: 37371625].
11. Azizi A, Rezaee M. Comparison of periodontal status in gingival oral lichen planus patients and healthy subjects. Dermatol Res Pract. 2012;2012:561232. [PMID: 22570646].
12. Gabusi A, Stefanini M, Gissi DB, et al. Surgical management of gingival recessions in patients with refractory gingival pemphigus vulgaris: A multidisciplinary challenge. Clin Adv Periodontics. 2023. [PMID: 36733218].
13. Arduino PG, Farci V, D'Aiuto F, et al. Periodontal status in oral mucous membrane pemphigoid: initial results of a case-control study. Oral Dis. 2011;17:90-4. [PMID: 20659265].
14. Thorat MS, Raju A, Pradeep AR. Pemphigus vulgaris: effects on periodontal health. J Oral Sci. 2010;52:449-54. [PMID: 20881339].
15. Handelman CS, Eltink AP, BeGole E. Quantitative measures of gingival recession and the influence of gender, race, and attrition. Prog Orthod. 2018;19:5. [PMID: 29376198].
16. Miller PD, Jr. A classification of marginal tissue recession. Int J Periodontics Restorative Dent. 1985;5:8-13. [PMID: 3858267].
17. Pini-Prato G. The Miller classification of gingival recession: limits and drawbacks. J Clin Periodontol. 2011;38:243-5. [PMID: 21158897].
18. Zweers J, Thomas RZ, Slot DE, et al. Characteristics of periodontal biotype, its dimensions, associations and prevalence: a systematic review. J Clin Periodontol. 2014;41:958-71. [PMID: 24836578].
19. Cairo F, Nieri M, Cincinelli S, et al. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study. J Clin Periodontol. 2011;38:661-6. [PMID: 21507033].
20. Cortellini P, Bissada NF. Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. J Periodontol. 2018;89 Suppl 1:S204-s13. [PMID: 29926948].
21. Diana M, Nikhat F. “Gingival Recession And Root Coverage Up To Date, A literature Review”. Dentistry Review. 2022;2:100008. [doi: https://doi.org/10.1016/j.dentre.2021.100008].
22. Chan HL, Chun YH, MacEachern M, Oates TW. Does Gingival Recession Require Surgical Treatment? Dent Clin North Am. 2015;59:981-96. [PMID: 26427577].
23. Duffy JM, Latimer JM, Fried RM, Dragan IF. Minimally Invasive Coronally Advanced Flap Techniques for Correction of Gingival Recession Defects: A Review. Compend Contin Educ Dent. 2023;44:36-41. [PMID: 36696277].
24. Chambrone L, Pannuti CM, Tu YK, Chambrone LA. Evidence-based periodontal plastic surgery. II. An individual data meta-analysis for evaluating factors in achieving complete root coverage. J Periodontol. 2012;83:477-90. [PMID: 21859324].
25. Kao RT, Pasquinelli K. Thick vs. thin gingival tissue: a key determinant in tissue response to disease and restorative treatment. J Calif Dent Assoc. 2002;30:521-6. [PMID: 12216915].
26. De Rouck T, Eghbali R, Collys K, et al. The gingival biotype revisited: transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J Clin Periodontol. 2009;36:428-33. [PMID: 19419444].
27. Chambrone L, Sukekava F, Araújo MG, et al. Root-coverage procedures for the treatment of localized recession-type defects: a Cochrane systematic review. J Periodontol. 2010;81:452-78. [PMID: 20367089].
28. Heasman PA, Holliday R, Bryant A, Preshaw PM. Evidence for the occurrence of gingival recession and non-carious cervical lesions as a consequence of traumatic toothbrushing. J Clin Periodontol. 2015;42 Suppl 16:S237-55. [PMID: 25495508].
29. Jati AS, Furquim LZ, Consolaro A. Gingival recession: its causes and types, and the importance of orthodontic treatment. Dental Press J Orthod. 2016;21:18-29. [PMID: 27409650].
30. Toker H, Ozdemir H. Gingival recession: epidemiology and risk indicators in a university dental hospital in Turkey. Int J Dent Hyg. 2009;7:115-20. [PMID: 19413547].
31. McCracken GI, Heasman L, Stacey F, et al. The impact of powered and manual toothbrushing on incipient gingival recession. J Clin Periodontol. 2009;36:950-7. [PMID: 19811584].
32. Graetz C, Plaumann A, Heinevetter N, et al. Bristle splaying and its effect on pre-existing gingival recession-a 12-month randomized controlled trial. Clin Oral Investig. 2017;21:1989-95. [PMID: 27796575].
33. Dörfer CE, Staehle HJ, Wolff D. Three-year randomized study of manual and power toothbrush effects on pre-existing gingival recession. J Clin Periodontol. 2016;43:512-9. [PMID: 26810391].
34. Sanz M, Bäumer A, Buduneli N, et al. Effect of professional mechanical plaque removal on secondary prevention of periodontitis and the complications of gingival and periodontal preventive measures: consensus report of group 4 of the 11th European Workshop on Periodontology on effective prevention of periodontal and peri-implant diseases. J Clin Periodontol. 2015;42 Suppl 16:S214-20. [PMID: 25626357].
35. Matas F, Sentís J, Mendieta C. Ten-year longitudinal study of gingival recession in dentists. J Clin Periodontol. 2011;38:1091-8. [PMID: 22092502].
36. Daprile G, Gatto MR, Checchi L. The evolution of buccal gingival recessions in a student population: a 5-year follow-up. J Periodontol. 2007;78:611-4. [PMID: 17397306].
37. Page RC, Engel LD, Narayanan AS, Clagett JA. Chronic Inflammatory Gingival and Periodontal Disease. JAMA. 1978;240:545-50. [PMID: 678330]
38. Kwon T, Lamster IB, Levin L. Current Concepts in the Management of Periodontitis. Int Dent J. 2021;71:462-76. [PMID: 34839889].
39. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Periodontology. 2018;89:S159-S72. [PMID: 29926952]
40. Merijohn GK. Management and prevention of gingival recession. Periodontol 2000. 2016;71:228-42. [PMID: 27045439].
41. Weitman RT, Eames WB. Plaque accumulation on composite surfaces after various finising procedures. J Am Dent Assoc. 1975;91:101-6. [PMID: 166101].
42. Liu Y, Li CX, Nie J, et al. Interactions between Orthodontic Treatment and Gingival Tissue. Chin J Dent Res. 2023;26:11-8. [PMID: 36988062].
43. Clark D, Levin L. Non-surgical management of tooth hypersensitivity. Int Dent J. 2016;66:249-56. [PMID: 27301300].
44. Naghsh N, Kachuie M, Kachuie M, Birang R. Evaluation of the Effects of 660-nm and 810-nm Low-Level Diode Lasers on the Treatment of Dentin Hypersensitivity. J Lasers Med Sci. 2020;11:126-34. [PMID: 32273952].
45. Yilmaz HG, Kurtulmus-Yilmaz S, Cengiz E, et al. Clinical evaluation of Er,Cr:YSGG and GaAlAs laser therapy for treating dentine hypersensitivity: A randomized controlled clinical trial. J Dent. 2011;39:249-54. [PMID: 21238531].
46. Praveen R, Thakur S, Kirthiga M, Narmatha M. Comparative evaluation of a low-level laser and topical desensitizing agent for treating dentinal hypersensitivity: A randomized controlled trial. J Conserv Dent. 2018;21:495-9. [PMID: 30294109].
47. Maximiano V, Machado AC, Yoshida ML, et al. Nd:YAG laser and calcium sodium phosphosilicate prophylaxis paste in the treatment of dentin hypersensitivity: a double-blind randomized clinical study. Clin Oral Investig. 2019;23:3331-8. [PMID: 30506227].
48. He S, Wang Y, Li X, Hu D. Effectiveness of laser therapy and topical desensitising agents in treating dentine hypersensitivity: a systematic review. J Oral Rehabil. 2011;38:348-58. [PMID: 21223353].
49. Sgolastra F, Petrucci A, Gatto R, Monaco A. Effectiveness of laser in dentinal hypersensitivity treatment: a systematic review. J Endod. 2011;37:297-303. [PMID: 21329811].
50. Alani A, Maglad A, Nohl F. The prosthetic management of gingival aesthetics. Br Dent J. 2011;210:63-9. [PMID: 21252883].
51. Shah R, M GT, Thomas R, Mehta DS. An Update on the Protocols and Biologic Actions of Platelet Rich Fibrin in Dentistry. Eur J Prosthodont Restor Dent. 2017;25:64-72. [PMID: 28590091].
52. Ozsagir ZB, Saglam E, Sen Yilmaz B, et al. Injectable platelet-rich fibrin and microneedling for gingival augmentation in thin periodontal phenotype: A randomized controlled clinical trial. J Clin Periodontol. 2020;47:489-99. [PMID: 31912532].
53. Kavi S, Panchal A, Shah R, et al. A New Approach for Increasing the Gingival Thickness by Using Injectable Platelet Rich Fibrin (i-PRF) – A Clinical and Radiographic Study. International journal of scientific research. 2021:1-3. [DOI: 10.36106/ijsr/6101541].
54. Fotani S, Shiggaon LB, Waghmare A, et al., editors. Effect of injectable platelet rich fibrin (i-PRF) on thin gingival biotype: A clinical trial. Journal of Applied Dental and Medical Sciences. 2019;5:10-16.
55. Manasa B, Baiju KV, Ambili R. Efficacy of injectable platelet-rich fibrin (i-PRF) for gingival phenotype modification: a split-mouth randomized controlled clinical trial. Clin Oral Investig. 2023;27:3275-83. [PMID: 36920546].
56. Mishra AK, Kumathalli K, Sridhar R, et al. Comparison of semilunar coronally repositioned flap with gingival massaging using an Ayurvedic product (irimedadi taila) in the treatment of class-I gingival recession: A clinical study. World J Clin Cases. 2014;2:534-40. [PMID: 25325064].
57. Levine WZ, Samuels N, Bar Sheshet ME, Grbic JT. A novel treatment of gingival recession using a botanical topical gingival patch and mouthrinse. J Contemp Dent Pract. 2013;14:948-53. [PMID: 24685803].
58. Zhao XH, Tay FR, Fang YJ, et al. Topical application of phenytoin or nifedipine-loaded PLGA microspheres promotes periodontal regeneration in vivo. Arch Oral Biol. 2019;97:42-51. [PMID: 30342306].
59. Schroeder, K.D. File:Human tooth diagram-en.svg [Image]. 2016. Wikimedia Commons. https://commons.wikimedia.org/w/index.php?curid=52624520##. Accessed September 28, 2024.
60. DRosenbach. Gingival tissue [Image]. 2014. Wikimedia Commons. https://commons.wikimedia.org/w/index.php?curid=37562771. Accessed September 28, 2024.
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