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Focused Clinical Question: With the 2018 AAP/EFP disease classification with the staging and grading systems, does risk assessment for different ethnic group result in a different focus for clinical needs? This comparative analysis aimed to assess two previously reported cohort studies in African‐American (Af‐A) and Asian‐American (As‐A) as to the risk for these two populations for clinical attachment loss (CAL) and gingival phenotype. Summary: In comparison of As‐A and Af‐A cohorts, As‐A had higher frequency of thin tissue phenotype, less width of keratinized gingiva (KGW), and more gingival recession (GR). On other hands, Af‐A showed higher prevalence of thick phenotype, longer total tooth length and root length (RL). These gingival and dental anatomical patterns suggest there are differential risk for GR, patterns for CAL, and periodontal prognosis between two cohorts. Conclusion(s): Because of nature of dental and gingival anatomy between these two cohorts, As‐A are more susceptible in GR and the short RL affords this population less ability to withstand the clinical presentation of periodontal disease. From a therapeutic perspective, clinicians should evaluate patients with different risk assessment based on their dental and gingival characterization. Af‐A may have clinical characteristics that makes this population less at risk for mucogingival defects. Conversely, phenotype modification therapy should be considered when treating As‐A because of the high prevalence of thin tissue phenotype, inadequate KGW, and GR. Clinicians should also diligently monitor periodontal CAL around the teeth with shorter RL in periodontal or orthodontic therapy for better teeth prognosis. [ABSTRACT FROM AUTHOR]

Background: There is disagreement on the specific mechanism through which the economic recession increased suicides in Greece. Unemployment is considered by many authors to be the determining factor but the data are inconclusive and often negative, especially concerning the temporal relationship between onset of increase in unemployment and increase in suicides AIMS: The aim of this paper was to clarify the specific role of unemployment as well as of other socioeconomic variables on specific age-by-gender groups concerning the increase in suicides.Methods: Data of the Hellenic Statistical Authority ELSTAT (www.Statistics: gr) were analyzed with Linear Regression Analysis and Bonferroni correction for multiple testing RESULTS: Unemployment correlates with suicide rates only in males aged 20-24, 50-54 and 60-64 years (p < 0.001). Unemployment could held responsible for an additional 148 male deaths during the period 2009-2015, which accounts for 5.3% of the total (29 additional deaths per year). The changes in all the socioeconomic conditions could held responsible for 317 cases of suicide or 9.4% of total CONCLUSIONS: The results of the current study suggest that there was a 33% increase in deaths by suicide in Greece during the early years of recession (2009-2015); one third could be directly attributed to unemployment, one third to other consequences of recession while another third is of unknown origin. The effect of unemployment is specifically restricted to males at the beginning of their working career (20-24 years old) and to middle aged (45-49 and 55-59 years old). [ABSTRACT FROM AUTHOR]

The aim of this cross-sectional study was to determine, în a group of patients, the prevalence of gingival recession (GR) and to assess its risk factors by making correlations between GR and demographic, dental, etiological items. Material and method. The study was carried ouţ on a batch of 422 patients, aged 20-59 years, who showed up at a private practice în Bucharest during 2016-2018. Data collection was performed by questionnaire method and clinical examination with mirror and periodontal probe; the presence of GR was measured în mm, from cementum-enamel junction (CEJ) to the gingival margin on facial and oral surfaces of all teeth and was reported according to Miller's classification, into 4 classes. The Silness-Löe plaque index (PI) and the degree of evolution by determining the extension în the surface, according to Marini's criteria were calculated. The data were analyzed using SPSS software version 20, and Chi-Square test for the comparative analysis. Results and discussions. GR prevalence was 66%, with greater impairment în older patients (19% în the 20-29 age group to 30% în the 50-59 age group), în males (55%) and lower incisors. Statistical analysis showed the presence of statistical significance between GR and the analyzed etiological factors (presence of plaque, type of brushing, dental changes (position, location, shape), biotype, history of orthodontic treatments, endocrine changes and premenopause). Smoking and drinking alcohol were also considered predisposing factors. The study showed that there îs a statistically significant correlation between smoking and the presence of hygiene, brushing and dental malpositions and also an association between the degree of education and analyzed etiologic factors. Conclusions. More than half of the examined patients shows GR. Plaque, brushing type, dental changes, biotype, orthodontic treatments, endocrine and premenopausal changes, smoking and alcohol consumption are etiological factors significantly associated with GR appearance. [ABSTRACT FROM AUTHOR]

To identify gingival recession-related biomarkers in orthodontic patients, we compared the proteome of gingival crevicular fluids (GCF) from healthy gingiva without orthodontic treatment (GH), healthy gingiva undergoing orthodontic treatment (OGH), and recessed gingiva undergoing orthodontic treatment (OGR). GCF samples were obtained from the anterior teeth of 15 volunteers (n = 5/group). Quantitative proteomic analysis was performed using DIA-based liquid chromatography-tandem mass spectrometry (LC-MS/MS). Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were used to annotate differentially expressed proteins (DEPs). Receiver-operating characteristic (ROC) analysis was performed to detect and filter biomarker candidates, while Protein-Protein Interaction (PPI) Networks were utilized to determine the interactions between these DEPs. A total of 253, 238, and 101 DEPs were found in OGR vs. OGH, OGR vs. GH, and OGH vs. GH groups, respectively. Based on the Venn diagram of three groups, 128 DEPs in OGR vs. OGH group were identified as specific proteins associated with progressive gingival recession (GR) during orthodontic treatment. Molecular function analysis showed that 128 DEPs were enriched in "molecular binding", including antigen binding, RNA binding, double-stranded RNA binding, cadherin binding involved in cell-cell adhesion, vinculin binding, S100 protein binding, and Ral GTPase binding. The majority of these DEPs were also involved in cytoskeletal regulation. In addition, biological process analysis showed an enrichment in translation, while cellular component analysis indicated that 128 DEPs were related to extracellular exosome. Furthermore, Ribosome and Phagosome were the top two terms in KEGG analysis. The results of ROC analysis demonstrated that 26 proteins could be potential biomarker candidates for GR. PPI networks analysis predicted that IQGAP1, ACTN1, TLN1, VASP, FN1, FERMT3, MYO1C, RALA, RPL35, SEC61G, KPNB1, and NPM1 could be involved in the development of GR via cytoskeletal regulation. In summary, we identified several GCF proteins associated with GR after orthodontic treatment. These findings could contribute to the prevention of GR in susceptible patients before the initiation of orthodontic treatment. Orthodontic patients with GR often report esthetic defects or root hypersensitivity during orthodontic treatment, especially at the anterior teeth site. GCF, rich in protein, is an easily accessible source of potential biomarkers for the diagnosis of periodontal diseases; however, little is known about the changes in GCF proteome associated with GR in orthodontic patients. In this study we firstly used DIA-based LC-MS/MS to evaluate the proteome and to identify the biomarker candidates for GR in orthodontic patients. These findings will improve our understanding of GR during orthodontic treatment, and could contribute to an earlier diagnosis, or even prevention, of GR in susceptible populations before orthodontic treatment. [Display omitted] • Orthodontic patients with progressive (GR have unique protein expression profile compared to subjects without GR. • Some orthodontic patients would be more susceptible to orthodontic force to result in GR. • Force-sensitive cytoskeleton-related proteins may be crucial moleculars to regulate alveolar bone remodeling and leading to GR. [ABSTRACT FROM AUTHOR]

Background A newly developed collagen matrix ( CM) of porcine origin has been shown to represent a potential alternative to palatal connective tissue grafts ( CTG) for the treatment of single Miller Class I and II gingival recessions when used in conjunction with a coronally advanced flap ( CAF). However, at present it remains unknown to what extent CM may represent a valuable alternative to CTG in the treatment of Miller Class I and II multiple adjacent gingival recessions ( MAGR). The aim of this study was to compare the clinical outcomes following treatment of Miller Class I and II MAGR using the modified coronally advanced tunnel technique ( MCAT) in conjunction with either CM or CTG. Methods Twenty-two patients with a total of 156 Miller Class I and II gingival recessions were included in this study. Recessions were randomly treated according to a split-mouth design by means of MCAT + CM (test) or MCAT + CTG (control). The following measurements were recorded at baseline (i.e. prior to surgery) and at 12 months: Gingival Recession Depth ( GRD), Probing Pocket Depth ( PD), Clinical Attachment Level ( CAL), Keratinized Tissue Width ( KTW), Gingival Recession Width ( GRW) and Gingival Thickness ( GT). GT was measured 3-mm apical to the gingival margin. Patient acceptance was recorded using a Visual Analogue Scale ( VAS). The primary outcome variable was Complete Root Coverage ( CRC), secondary outcomes were Mean Root Coverage ( MRC), change in KTW, GT, patient acceptance and duration of surgery. Results Healing was uneventful in both groups. No adverse reactions at any of the sites were observed. At 12 months, both treatments resulted in statistically significant improvements of CRC, MRC, KTW and GT compared with baseline ( p < 0.05). CRC was found at 42% of test sites and at 85% of control sites respectively ( p < 0.05). MRC measured 71 ± 21% mm at test sites versus 90 ± 18% mm at control sites ( p < 0.05). Mean KTW measured 2.4 ± 0.7 mm at test sites versus 2.7 ± 0.8 mm at control sites ( p > 0.05). At test sites, GT values changed from 0.8 ± 0.2 to 1.0 ± 0.3 mm, and at control sites from 0.8 ± 0.3 to 1.3 ± 0.4 mm ( p < 0.05). Duration of surgery and patient morbidity was statistically significantly lower in the test compared with the control group respectively ( p < 0.05). Conclusions The present findings indicate that the use of CM may represent an alternative to CTG by reducing surgical time and patient morbidity, but yielded lower CRC than CTG in the treatment of Miller Class I and II MAGR when used in conjunction with MCAT. [ABSTRACT FROM AUTHOR]

Objective: The current cross-sectional study aimed to investigate the prevalence of gingival recession (REC) in a sample of young individuals. In addition, the association with several risk factors was examined., Materials & Methods: A 104 subjects, aged 18-30 years old, were randomly enrolled in the study. Participants were requested to fill in a simple structured questionnaire in order to provide information on dental hygiene habits, educational level, smoking and history of orthodontic treatment. Afterwards, all the included individuals were subjected to a thorough clinical periodontal examination including gingival recession (REC), gingival biotype, plaque levels and gingival bleeding index (GBI) assessment., Results: The mean prevalence of REC in the studied population surpassed 50% with an equal distribution among females and males. The most common teeth associated with REC were the lower left canine and left 1st premolar. Among the examined variables, only the bleeding index was found to be associated with the presence of REC., Conclusions: Gingival recession was a prevalent condition among young individuals. Gingival inflammation was found to be the most significant factor affecting the incidence of REC., (© 2021 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Collagen (Col) is a naturally available material and is widely used in the tissue engineering and medical field owing to its high biocompatibility and malleability. Promising results on the use of Col were observed in the periodontal application and many attempts have been carried out to inculcate Col for gingival recession (GR). Col is found to be an excellent provisional bioscaffold for the current treatment in GR. Therefore, the aim of this paper is to scrutinize an overview of the reported Col effect focusing on in vitro, in vivo, and clinical trials in GR application. A comprehensive literature search was performed using EBSCOhost, Science Direct, Springer Link, and Medline & Ovid databases to identify the potential articles on particular topics. The search query was accomplished based on the Boolean operators involving keywords such as (1) collagen OR scaffold OR hybrid scaffold OR biomaterial AND (2) gingiva recession OR tissue regeneration OR dental tissue OR healing mechanism OR gingiva. Only articles published from 2015 onwards were selected for further analysis. This review includes the physicochemical properties of Col scaffold and the outcome for GR. The comprehensive literature search retrieved a total of 3077 articles using the appropriate keywords. However, on the basis of the inclusion and exclusion criteria, only 15 articles were chosen for further review. The results from these articles indicated that Col promoted gingival tissue regeneration for GR healing. Therefore, this systematic review recapitulated that Col enhances regeneration of gingival tissue either through a slow or rapid process with no sign of cytotoxicity or adverse effect. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present cross-sectional study was to estimate gingival recession (GR) prevalence and associated risk factors in young Greek adults., Methods: The study population consisted of 420 young adults (200 males and 220 females). All individuals were clinically examined and answered questions regarding their smoking status, educational level, and oral hygiene practices. In addition, the association between GR and the following aspects was assessed: sex, smoking status, educational level, plaque index, gingival index, calculus presence, and plaque control methods. Statistical analysis of data was accomplished using the multivariate linear regression analysis model., Results: The average number of GR overall was 1.38 mm (standard deviation: 0.18 mm). Gingival index (P = 0.000) and smoking (P = 0.01) were the most important associated risk factors of GR, while sex, oral hygiene practices, presence of supragingival calculus, educational level, and plaque index were not significantly associated with it., Conclusion: Gingival inflammation, as determined by the gingival index, and smoking were the most important associated risk factors of GR., (© 2013 Wiley Publishing Asia Pty Ltd.)