Clinical comparison between different surgical techniques used to manage advanced gingival recession (Miller's class III & IV)

A novel approach to managing gingival recession in protruded roots: a case report

This case report presents an innovative approach to managing severe isolated gingival recession associated with root protrusion beyond bone boundaries in a 28-year-old female patient. The patient, who had a history of orthodontic treatment for a 5-year-period, displayed significant gingival recession at the lower right central incisor. Conventional orthodontic repositioning was declined by the patient, leading to the adoption of an alternative treatment strategy. A combination of odontoplasty to trim the protruding root (~1 mm) and a connective tissue graft was employed. The procedure involved meticulous flap creation, root surface biomodification, and precise graft placement to achieve optimal functional and esthetic outcomes. Follow-up over 3 months revealed increased keratinized tissue thickness and complete root coverage, with high patient satisfaction. This novel technique demonstrates the potential to address complex recession cases effectively, preserving root structure and enhancing graft vascularization. Further research is warranted to validate these findings across broader clinical scenarios.

The Prevalence of Gingival Recession According to the Cairo Classification in a Population from the North of Portugal

Background/Objectives: Gingival recession (GR) has a multifactorial etiology, resulting from the interaction of various factors. It affects aesthetics and comfort, and has negative consequences for quality of life. The main objective of this study is to investigate the prevalence of gingival recession in a sample of the population in northern Portugal, according to the classification system proposed by Cairo. The secondary objective is to investigate possible risk factors for the prevalence of gingival recession. Methods: This observational study analyzed 50 patients who met all our inclusion criteria. Participants underwent a clinical periodontal examination and completed a questionnaire. Results: On the lingual/palatine side, recession type 2 (RT2) was the most prevalent (39.1%), and on the buccal side, recession type 3 (RT3) was the most prevalent (37.7%). Statistically significant differences were found in the occurrence of RT3 on both sides, buccal and lingual/palatine, which was higher in patients over 65. Buccal side RT2 and buccal and lingual/palatine side RT3 were more prevalent in males. Buccal side RT2 was more prevalent in ex-smokers compared to nonsmokers. RT3 was more prevalent in ex-smokers compared to smokers and nonsmokers. Most patients have gingival recession with loss of interproximal attachment. Conclusions: Older age, male gender, high plaque levels, and smoking habits are considered risk factors.

Biofabrication Strategies for Oral Soft Tissue Regeneration

Gingival recession, a prevalent condition affecting the gum tissues, is characterized by the exposure of tooth root surfaces due to the displacement of the gingival margin. This review explores conventional treatments, highlighting their limitations and the quest for innovative alternatives. Importantly, it emphasizes the critical considerations in gingival tissue engineering leveraging on cells, biomaterials, and signaling factors. Successful tissue-engineered gingival constructs hinge on strategic choices such as cell sources, scaffold design, mechanical properties, and growth factor delivery. Unveiling advancements in recent biofabrication technologies like 3D bioprinting, electrospinning, and microfluidic organ-on-chip systems, this review elucidates their precise control over cell arrangement, biomaterials, and signaling cues. These technologies empower the recapitulation of microphysiological features, enabling the development of gingival constructs that closely emulate the anatomical, physiological, and functional characteristics of native gingival tissues. The review explores diverse engineering strategies aiming at the biofabrication of realistic tissue-engineered gingival grafts. Further, the parallels between the skin and gingival tissues are highlighted, exploring the potential transfer of biofabrication approaches from skin tissue regeneration to gingival tissue engineering. To conclude, the exploration of innovative biofabrication technologies for gingival tissues and inspiration drawn from skin tissue engineering look forward to a transformative era in regenerative dentistry with improved clinical outcomes.