Quantitative measures of gingival recession and the influence of gender, race, and attrition

Chester S. Handelman, Anthony P. Eltink, Ellen BeGole

Gingival recession in dentitions with otherwise healthy periodontium is a common occurrence in adults. Recession is clinically measured using a periodontal probe to the nearest millimeter. The aim of this study is to establish quantitative measures of recession, the clinical crown height, and a new measure the gingival margin-papillae measurement. The latter is seen as the shortest apico-coronal distance measured from the depth of the gingival margin to a line connecting the tips of the two adjacent papillae. Measurements on all teeth up to and including the first molar were performed on pretreatment study models of 120 adult Caucasian and African-American subjects divided into four groups of 30 by gender and race. Both the clinical crown height and the gingival margin-papillae measurements gave a true positive result for changes associated with gingival recession. Tooth wear shortens the clinical crown, and therefore, the measure of clinical crown height can give a false negative result when gingival recession is present. However, the gingival margin-papillae measurement was not affected by tooth wear and gave a true positive result for gingival recession. Tooth wear (attrition) was not associated with an increase in gingival recession. These measures are also useful in detecting recession prior to cemental exposure. Measures for recession and tooth wear were different for the four demographic groups studied. These measures can be used as quantitative standards in both clinical dentistry, research, and epidemiological studies.