Assessment of Negative Gingival Recession: A Critical Component of Periodontal Diagnosis

Abstract

Accurate measurement of negative gingival recession (GR) is essential to accurately determine the clinical attachment loss, which leads to an accurate diagnosis and optimal therapy of periodontal disease. However, the accuracy of measuring the negative GR has been shown to be low and highly variable between examiners. The position of the gingiva margin in relation to the cemento-enamel junction (CEJ) varies among different stages of passive eruption. The amount of negative GR is about 2 mm on average at the mid-facial sites and ranges from 2 to 3.5 mm at interproximal sites in periodontally healthy patients. Some other clinical conditions may change the gingival dimension coronal to the CEJ, such as altered passive eruption and gingival enlargement. In addition to the traditional approach using a periodontal probe to assess the negative GR, nowadays dental ultrasound imaging may be able to assist in accurately measuring the amount of negative GR. This narrative review will discuss the existing evidence of the dimension of dentogingival tissue and the clinical assessment of negative GR using different clinical tools.

Altered Passive Eruption among Patients Visiting Dental Outpatient Department in a Tertiary Care Center: A Descriptive Cross-sectional Study

“…It has been sometimes referred to as negative gingival recession which indicates the coronal position of marginal gingiva. 7 There are four stages of passive eruption namely I-IV as per Gargiulo et al 8 Stage I is where we can appreciate negative recession >2 mm whereas stage IV is considered pathological with gingival recession and loss of attachment. 8 The prevalence of altered passive eruption in our study i.e.…”

“…But, in the areas where CEJ is obliterated like in cases of cervical abrasion, it is quite difficult to diagnose. 7 One of the main causes of APE is excessive gingival display and management protocol is with simple gingivectomy or gingivectomy with osseous reduction. 15 The crown lengthening procedure, where there is APE along with thick gingival biotype is suggested to go with the osseous reduction technique as most often, the alveolar crest is slightly coronal to its normal position and there is a tendency of higher tissue rebound in thick tissues compared to thinner ones.…”