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Objective: This systematic review and meta‐analysis aimed to estimate the global prevalence of gingival recession (GR) in the general population. Materials and Methods: Population‐based observational studies reporting the prevalence of GR and published from 1991 to 2021 were identified from five electronic databases and manual searches. Risk of bias was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Prevalence Studies. The pooled prevalence of GR was calculated by using a random‐effect model. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to summarize the overall certainty of evidence. Results: A total of 15 studies involving 37,460 participants were included. The overall pooled prevalence was 78.16% at the minimal reported threshold values and 84.92% at ≥1 mm "cut‐off" with high heterogeneity among studies. A separate analysis for the buccal GR revealed a pooled prevalence of 75.42%. The risk of bias was found to be high for 10 and low for 5 studies. The overall certainty of the evidence was assessed to be very low. Conclusion: More than two‐thirds of the population worldwide was found to be affected by GR. Studies with standard case definition and less heterogeneity are required to accurately estimate the prevalence of GR. [ABSTRACT FROM AUTHOR]

Presence of adequate dimensions of keratinized/ attached gingiva (KT/AG) and gingival thickness (GT) is considered necessary to maintain optimal periodontal health and long-term stability of gingival margin. Gingival phenotype modification therapies to increase these two dimensions (GT and KT/AG) on the buccal aspect of teeth have been widely reported, but the literature on lingual gingival augmentation is scarce. The purpose of this paper is to report the outcomes of a case treated with an envelope flap combined with a hybrid soft tissue autograft (subepithelial connective tissue graft with an epithelial collar) for phenotype modification of gingiva lingual to mandibular incisors presenting with thin gingiva (<1 mm) and lack of AG in tooth # 31 and 42. At 12 months follow-up, a substantial gain in KT, AG and GT along with partial root coverage was achieved. [ABSTRACT FROM AUTHOR]

Preserving a sufficient blood supply and maintaining wound stability during the healing phase are the most crucial factors for success in root coverage procedures. Selecting the surgical technique and suturing protocol used to achieve these goals is therefore indispensable for predictable treatment outcomes. Tunneling flap procedures have evolved as a technical advancement in periodontal plastic surgery, particularly focusing on improving the vascular supply at the surgical site. Along with the development of newer flap designs for recession coverage, several suturing protocols for flap stability have been described. This paper illustrates the use of a modified suturing method for soft tissue graft stabilization in a coronally advanced tunnel flap procedure for the treatment of isolated gingival recession. It allows precise three-dimensional positioning and tripod stabilization of the graft in the tunnel as an independent step, differing from previously described techniques. A modified tissue-supported vertical mattress suture is then placed for coronal advancement and improved wound adaptation. The present authors have found that the proposed suturing protocol achieves successful integration of graft, maximum root coverage, excellent esthetic results, and limited postoperative morbidity. The suturing technique is described in detail with schematic illustrations and clinical cases, and its advantages and potential limitations are discussed. [ABSTRACT FROM AUTHOR]

Gingival recession (GR) is considered a public health problem which is highly prevalent across different populations. Accuracy of psychometric properties of prevalence estimates of GR reported in epidemiological studies is important to facilitate setting public health goals, planning of public health programs, implementation of best practices and thereby developing public health policy. However, the reported prevalence estimates are influenced by the methodological variations among different studies, as observed in our recently published systematic review and meta-analysis on the global prevalence of GR. It substantially limits the comparability between studies and inferences about the true global variation in the prevalence of GR are difficult to establish. To address these issues, this commentary suggests to follow the standardized principles related to study design, clinical examination protocol, and characteristics of study subjects in future epidemiological studies on prevalence estimates of GR. Furthermore, the inclusion of additional domains in the reporting data is suggested for a deeper insight into the patterns of GR in different populations. Our suggestions are derived from a pragmatic approach and their consistent implementation would improve the reporting quality and achieve uniformity in future studies, thus benefitting the research in this area. [ABSTRACT FROM AUTHOR]

Background: This study aims to describe the demographics and clinicopathological characteristics of the cases of plasma cell gingivitis (PCG) reported in our institute, supported by a review of pertinent literature. Further, we investigated the role of the cluster of differentiation CD138, Ki67, CD56, and CD117 immunoexpression in the differential diagnosis of PCG from plasma cell dyscrasias. Materials and Methods: All histopathologically confirmed cases of PCG, whose relevant details could be obtained, were included in this study. They were subjected to panel of immunohistochemical markers to exclude plasma cell malignancies. Further, published English literature for PCG since 1970-2020 was reviewed. Results: Nine histopathologically confirmed cases of PCG, were retrieved from the archives of our department. The cases comprised 3 males and 6 females with their ages ranging between 14 and 82 years. The plasma cells exhibited equivocal reactivity for kappa and lambda; and immunonegativity for CD56, CD117 with low Ki67 proliferation index. Published literature in English showed 43 cases of PCG were predominantly female; the diffuse involvement of maxilla and mandible was a common finding. Conclusion: In addition to kappa lambda reactivity, an immunoprofile of CD138, Ki67, CD56, and CD117 may be used as a diagnostic adjunct to exclude malignant plasma cell lesions in confusing cases. [ABSTRACT FROM AUTHOR]

Objectives: Mucosal fenestrations are infrequent and often challenging to treat depending on the extent of soft and hard tissue destruction. This article presents the successful management of a relatively larger mucosal fenestration associated with complete absence of buccal bone plate in a mandibular incisor secondary to trauma‐induced periapical pathosis. Clinical considerations: After non‐surgical endodontic therapy, surgery was performed for debridement of the osseous defect, root resection/shaping, connective tissue graft (CTG) placement on the affected root surface and platelet rich fibrin (PRF) in periapical osseous defect rather than use of bone graft and/or barrier membrane. Healing was uneventful, however, a small mucosal defect remained at 2 weeks follow‐up. After 3 months of primary surgery, a corrective surgery was performed utilizing an "incision‐free" approach i.e. tunnel technique with CTG in contrast to the contemporary flap approach. At 18 months follow‐up, complete closure of the mucosal defect with a thick gingival biotype, normal sulcus depth, and good esthetic outcome were achieved. No recurrence and any clinical signs of infection or inflammation were observed. Conclusions: Based on the outcomes of present case, an early intervention utilizing the minimally invasive surgical therapy and autologous biomaterials may be considered a viable approach to treat such complex lesions. Clinical significance: Endodontic therapy in combination with PRF and CTG appears to provide successful outcomes in treatment of a large mucosal fenestration with periapical osseous defect. [ABSTRACT FROM AUTHOR]

The treatment of multiple gingival recessions (GRs) is often challenging for clinicians, mainly due to a larger avascular surface, limited blood supply, differences in recession depth, and residual keratinized tissue. Considering these factors, it may be prudent to take advantage of one surgical technique and overcome its limitations by combining it with another technique in certain clinical situations. The present clinical report describes the treatment of multiple GRs of different depths with a combination of the tunnel technique (TUN) and pedicle flap (PED) -- double papilla flap (DPF) or coronally positioned flap (CPF) -- in conjunction with deepithelialized connective tissue grafts in two patients. The TUN was considered as it allows faster wound healing and improved esthetics due to the avoidance of visible incisions on the surface. However, to achieve complete coverage of the exposed root surface in the deep recession of the terminal tooth, the DPF or CPF were performed. Healing was uneventful, and no postoperative complications were observed. Complete root coverage was achieved in the treated teeth of both patients at the 12-month follow-up. The combination techniques described in this article can be utilized when there is a deep recession on one of the terminal teeth and the remaining teeth exhibit shallow to moderate recession depths. Clinicians should consider the amalgamation of surgical techniques to achieve the goals of complete root coverage in order to meet patients' esthetic and functional demands while at the same time minimizing postsurgical morbidity. [ABSTRACT FROM AUTHOR]

The use of magnification to perform various procedures in medical and dental field, particularly endodontics has long been recognized. Unfortunately, its application in periodontics is not widely popularized. The objective of this article is to emphasize the application of microsurgical principles in various periodontal surgical procedures and to reinforce the incorporation of microscope into periodontal practice. The most recent periodontal journals were reviewed and a search of databases such as PubMed or Medline and Google Scholar was conducted for relevant material from published literature up to 2017. Medical Subject Headings words looked for were "periodontal microsurgery" and "minimally invasive periodontal surgery." The available literature, specifically to periodontal surgical procedures was analyzed and compiled. The analysis indicates that incorporation of magnification in periodontal practice is associated with improved visual acuity, ergonomic benefits, decreased patient morbidity, rapid healing, and enhanced patient acceptance. [ABSTRACT FROM AUTHOR]

Background: The gingiva is a common site for neoplastic or non-neoplastic lesions. Neoplasms refer to progressive autonomous growth that can have either a benign or a malignant course. On the other hand, non-neoplastic lesions are mainly inflammatory, or occur as a reaction to some kind of irritation or lowgrade injury., Objectives: Assessing the frequency distribution of gingival lesions is important to optimize oral health care services. The present study retrospectively analyzed the frequency distribution of gingival lesions on the basis of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The secondary objective was to compare this system with the 1999 International Workshop classification system., Material and Methods: The hematoxylin and eosin (H&E)-stained histopathological slides of the gingival lesions reported over the last 3 years (2018-2020) were retrieved from the archive of the Division of Oral Pathology and Microbiology at a tertiary care hospital in New Delhi, India. Correlating clinical, radiological and pathological details enabled the categorization of lesions according to the new classification system., Results: In total, 73 gingival lesions were analyzed. Among these, reactive processes were the most frequent (39.73%), followed by inflammatory and immune conditions and lesions (26.03%), malignant tumors (21.92%), benign epithelial lesions (5.48%), and oral potentially malignant disorders (OPMDs) (5.48%). Genetic/developmental disorders were the least frequent (1.37%). However, as per the 1999 American Academy of Periodontology (AAP) system, the majority of lesions belonged to a non-specified category., Conclusions: The frequency distribution of biopsied gingival lesions according to the 2017 World Workshop classification in comparison with the previous classification system showed that differences between the 2 systems could be attributed to heterogeneous terminology rather than to real geographical variations.