European Group on Periodontal Research (ERGOPerio, CH); private practice, Florence, Italy.
Department of Periodontics, Case Western Reserve University, School of Dental Medicine, Cleveland, OH, USA.
J Clin Periodontol. 2018 Jun;45 Suppl 20:S190-S198. doi: 10.1111/jcpe.12948.
Mucogingival deformities, and gingival recession in particular, are a group of conditions that affect a large number of patients. Since life expectancy is rising and people are retaining more teeth both gingival recession and the related damages to the root surface are likely to become more frequent. It is therefore important to define anatomic/morphologic characteristics of mucogingival lesions and other predisposing conditions or treatments that are likely to be associated with occurrence of gingival recession.
Mucogingival defects including gingival recession occur frequently in adults, have a tendency to increase with age, and occur in populations with both high and low standards of oral hygiene. The root surface exposure is frequently associated with impaired esthetics, dentinal hypersensitivity and carious and non-carious cervical lesions. The objectives of this review are as follows (1) to propose a clinically oriented classification of the main mucogingival conditions, recession in particular; (2) to define the impact of these conditions in the areas of esthetics, dentin hypersensitivity and root surface alterations at the cervical area; and (3) to discuss the impact of the clinical signs and symptoms associated with the development of gingival recessions on future periodontal health status.
An extensive literature search revealed the following findings: 1) periodontal health can be maintained in most patients with optimal home care; 2) thin periodontal biotypes are at greater risk for developing gingival recession; 3) inadequate oral hygiene, orthodontic treatment, and cervical restorations might increase the risk for the development of gingival recession; 4) in the absence of pathosis, monitoring specific sites seems to be the proper approach; 5) surgical intervention, either to change the biotype and/or to cover roots, might be indicated when the risk for the development or progression of pathosis and associated root damages is increased and to satisfy the esthetic requirements of the patients.
The clinical impact and the prevalence of conditions like root surface lesions, hypersensitivity, and patient esthetic concern associated with gingival recessions indicate the need to modify the 1999 classification. The new classification includes additional information, such as recession severity, dimension of the gingiva (gingival biotype), presence/absence of caries and non-carious cervical lesions, esthetic concern of the patient, and presence/absence of dentin hypersensitivity.
黏膜炎性和牙龈退缩等黏膜-牙周组织变形是一组影响大量患者的病症。由于预期寿命延长，人们保留的牙齿也越来越多，因此牙龈退缩和与根面相关的损伤可能会更加频繁。因此，定义黏膜-牙周组织病损的解剖/形态特征以及可能与牙龈退缩发生相关的其他诱发因素或治疗方法非常重要。
成人中黏膜-牙周组织缺陷（包括牙龈退缩）很常见，其发生率随年龄增长而增加，且在口腔卫生水平高低不同的人群中均有发生。根面暴露常伴有美观受损、牙本质敏感和龋性及非龋性颈缘病变。本综述的目的如下：（1）提出一种以临床为导向的主要黏膜-牙周组织病损（特别是牙龈退缩）分类方法；（2）定义这些病损在美观、牙本质敏感和颈缘区域根面改变方面的影响；（3）讨论与牙龈退缩发生相关的临床体征和症状对未来牙周健康状况的影响。
广泛的文献检索结果如下：1）大多数患者通过最佳家庭护理可维持牙周健康；2）牙周组织薄型者发生牙龈退缩的风险更高；3）口腔卫生不良、正畸治疗和牙颈部修复体可能会增加发生牙龈退缩的风险；4）在无病变的情况下，监测特定部位似乎是恰当的方法；5）当发生或进展为疾病及相关根面损伤的风险增加且为满足患者美观需求时，可能需要进行手术干预，改变生物学类型和/或覆盖根面。
与牙龈退缩相关的根面病变、敏感和患者美观关注等病症的临床影响和流行率表明，需要修改 1999 年的分类方法。新的分类方法包含了更多信息，如退缩的严重程度、牙龈的大小（牙龈生物学类型）、有无龋病和非龋性颈缘病变、患者对美观的关注以及是否存在牙本质敏感。
