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Management & Prevention
of Gingival Recession
Workbook
George K. Merijohn, DDS San Francisco, California
______________________________________________________________________________ Assistant Clinical Professor, UCSF School of Dentistry, Dept. of Orofacial Sciences, Postgraduate Periodontology Affiliate Associate Professor, University of Washington School of Dentistry, Postdoctoral Periodontics
www.merijohn.com
©2015 George K. Merijohn, DDS All rights reserved Page 2
Table of Contents 1 Gingival Recession Today 3
2 Who is Susceptible? 3
3 What Causes It? 4
4 What Increases the Risk? 4
5 Essential Data Collection & Recording 5
6 Gingival Recession Interventions Work Session 7
7 When to Monitor and When to Consider Surgery 10
References 12 Gingival Recession Checklist and Chairside Visual Guide Gingival Recession Chairside Visual Guide
17 Each course participant may print one copy of the workbook for personal use.
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1. Gingival Recession Today
Gingival/soft tissue recession: The exposure of the root surface due to __________________
of the gingival/soft tissue margin past the cementoenamel junction (CEJ)18,53,91
Worldwide prevalence: % - % 2,45,47,55,56,79,84
Prevalence and severity increases with _______.2,55
United States: Prevalence of ≥1 mm recession in persons 30 years and older is _____%, and
averaged _______% teeth per person.2
Gingival recession in dental students and dentists 56:_______________________________
Gingival recession: Important to patients when it interferes with ______________________,
________________, or increases the risk of tooth loss due to _______________________ or
______________________.59
Prevalence of root caries experience in the U.S. has been reported to be ______% among
those aged 75+ years.37
Age group 65 and older (12% in 2000) is increasing and expected to exceed ______% by
2030 and ___________ is expected to increase along with it.37
2. Who is Susceptible?
Three major factors are associated with increased susceptibility to gingival recession, whether presenting independently or in combination: 59
1. Thin (delicate, fragile) Gingival Tissue 1,12,22,49,67,77
2. Mucogingival Conditions 5,41
Gingival/soft tissue recession Probe depth extends beyond the mucogingival junction Absence or narrow band (<2mm) of keratinized tissue
3. Positive History: Progressive gingival recession 81
Inflammatory periodontal disease(s) (e.g., plaque-induced gingivitis, localized chronic periodontitis) is a particularly important factor associated with gingival recession 2,79,81,94 especially for teeth with #1 &/or #2 above 59
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3. What Causes It?
Major causes of gingival recession: __________________________________ 79,81 and
mechanical (physical) abrasion/removal (e.g., _______________ oral hygiene practices or
_________________ dental procedures).27,35,40,43,45,55,76,79,83,89
Occasional causes:___________ and _____________ injury.40,76
4. What Increases the Risk?
Studies have reported several contributing factors and conditions commonly associated with
gingival recession and/or increasing recession. 8,45,54,56,76,77,79 Exposure to such factors and
conditions can make susceptible teeth particularly vulnerable to gingival recession.
Modifiable Conditions: Those common risk exposures associated with gingival recession that
lend themselves to ____________________ through conventional interventional therapy in the
clinical setting (Table 1). Table 1.Modifiable Conditions Associated with Gingival Recession
Clinical Tip: Decreasing the susceptible patients' exposure to modifiable conditions will decrease future risk for gingival recession and increase the likelihood of its long-term prevention.
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Identifying which patients are more ____________________ to gingival recession and which risk
exposures are __________________ in the clinical setting are essential first steps in developing
an action plan for the management and prevention of gingival recession.
5. Essential Data Collection and Recording
"The surest way to under-treat or over-treat gingival recession is through inadequate records"
Evaluation of the patient’s periodontal status requires obtaining a relevant medical and dental history and conducting a thorough clinical and radiographic examination with evaluation of extraoral and intraoral structures.5 The Parameter on Comprehensive Periodontal Examination developed by the American Academy of Periodontology states that all relevant clinical findings should be documented in the patients record.5
See Table 2 for recommendations regarding where to document in the patient record the susceptibility factors and modifiable conditions associated with gingival recession. 59 Table 2. Documenting Susceptibility Factors and Modifiable Conditions59
Clinical & Risk Management Tip: In order to establish a baseline and to most effectively track changes over time, all measurable/detectable essential clinical findings are recorded in the periodontal examination record. A comprehensive periodontal examination should be performed for all new patients and at appropriate periodic intervals based on the needs of the individual patient. 4,5
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See Figure 1 for an example of a comprehensive periodontal examination record that provides for data collection and recording for gingival recession susceptibility and modifiable risk factors. Figure 1. Periodontal Examination Record Example
www.perioaccess.com Q: How is periodontal charting data practically managed during dental hygiene/maintenance visits? A: Given the typical time allotment for dental hygiene appointments, for an adult patient with a relatively full complement of teeth and/or implants it is not always possible to perform and record a comprehensive periodontal examination in addition to performing other required assessments including: medical and dental health history update; review of radiographs; head and neck examination; appliance checks; caries and restoration check; scaling/root planing as needed; coronal polishing; oral hygiene review and instruction/training; lifestyle assessment and recommendations; and fluoride application (if needed).4,5 One must also consider the time it takes to greet and exit the patient as well as to perform operatory tear-down/disinfection and chairside set up. However, comprehensive periodontal evaluation [assessment) is a critically important component of the dental hygiene/maintenance appointment.5 A practical approach is to record on the periodontal maintenance record (see example in Figure 2), only significant negative changes comparing present findings to the most recent data on the periodontal examination record. (Figure 1). Q: Is comprehensive periodontal data recording/charting required at every hygiene visit?
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Figure 2. Periodontal Maintenance Record Example
www.perioaccess.com 6. Gingival Recession Interventions Work Session
Gingival Recession Checklist and Visual Guide is a practical chairside support tool that illustrates to the patient the gingival recession modifiable conditions that she or he can personally control. Especially with patients susceptible to gingival recession, mitigating these conditions will improve the chances for better management and prevention of gingival recession.59 Gingival Recession Checklist is especially helpful to the clinician when developing treatment plans. Its use during treatment/procedure planning can help guide the clinician toward options that can potentially decrease the risk of damage to tissues (e.g., mechanical abrasion/removal, inflammation, chemical, or thermal injury). This can help improve the odds of providing better management and prevention of gingival recession.59
Clinical Management/Treatment Plan Options Work Session: (Overview of 10 of the 14 Modifiable Conditions on Gingival Recession Checklist)
Poor metabolic control of diabetes
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Tobacco use including smokeless
Damaging oral hygiene methods contributing to inflammation/tissue injury
Damaging oral habits/eating habits contributing to inflammation/tissue injury
Bleeding on probing/inflammatory periodontal disease(s) (e.g., plaque-induced gingivitis, chronic periodontitis)
Clinically significant root sensitivity leading to avoidance of oral hygiene procedures
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Subgingival restorations contributing to inflammation despite effective oral hygiene and appropriate periodontal treatment
Oral appliances contributing to inflammation/tissue injury (e.g., oral jewelry, fixed orthodontic appliances, removable appliances)
Panned dental therapy that can cause inflammation or physical injury to the gingival tissues
Example: Potentially traumatic subgingival instrumentation:
Planned orthodontic tooth movement
Orthodontic treatment in general and the following retention phase are considered risk factors especially for the development of labial gingival recession.49,77 Use the Gingival Recession Checklist before, during and after orthodontic treatment. Patients susceptible to gingival recession will be more so during or after orthodontic treatment, especially if they present with modifiable conditions that are not addressed before, during, and after treatment. The prudent inter-disciplinary dental team will:
1. Determine whether the prospective orthodontic patient is susceptible to gingival recession
2. Consider adjusting tooth movement plans and outcomes 3. Recommend appropriate interventional periodontal therapy-especially for teeth at
increased risk for gingival recession
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7. When to Monitor and When to Consider Surgery 59
When to Monitor Gingival Recession Although individual patient circumstances may dictate otherwise, for patients presenting with: gingival/soft tissue recession; probing depths extending beyond the MGJ; absence or narrow band (< 2mm) of keratinized tissue; and/or thin (delicate, fragile) gingival tissue, it is proposed that the clinician can monitor gingival recession without surgical evaluation when all of the following criteria are met:4,59,60,63
No documented evidence of______________________ gingival recession Clinical attachment loss (probing depth plus gingival recession) is _______ mm
________ mm of gingival recession
All of the above and none of the following are planned involving the teeth in question Subgingival restorations Orthodontic tooth movement Oral appliances (e.g., oral jewelry, removable dental appliances) that can or will be in
contact with the tissue Potentially damaging dental therapy such as those treatments or procedures that can
cause inflammation or physical injury to the gingival tissues
When the Patient is a Candidate for Surgical Evaluation Although individual patient circumstances may determine otherwise, for patients presenting with: gingival/soft tissue recession; probing depths extending beyond the MGJ; absence or narrow band (< 2mm) of keratinized tissue; and/or thin (delicate, fragile) gingival tissue, it is proposed that the patient is a candidate for surgical evaluation when at least one of the following criteria are met: 4,59,60,63
Documented evidence of_____________________ gingival recession
___________________gingival inflammation despite appropriate therapeutic interventions and
also present with clinical attachment loss ______mm and/or gingival recession ______mm
____________________ gingival inflammation despite appropriate therapeutic interventions and
the inflammation is associated with:
Clinical Tips: Not all teeth presenting with thin gingival tissue, probing depth extending to or beyond the MGJ, &/or absence or narrow band of keratinized tissue will demonstrate gingival recession Surgical therapy is not warranted based solely on the presence of thin gingival tissue, probing depths extending beyond the MGJ, &/or absence or reduction of keratinized tissue. Lindhe J, Allen E, Maynard G Jr, Bruno J, Miller PD, Holbrook T, Wennstrőm J, Pini Prato G, Takei H. Consensus report. Mucogingival Therapy. Ann Periodontol 1996; 1: 702-706.
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___________ vestibular depth that restricts access for effective oral hygiene
___________ position that compromises effective oral hygiene
Tissue _____________ (cleft/fissure, etc.)
Any of the above and any of the following are planned for the teeth in question Subgingival restorations Orthodontic tooth movement Oral appliances that contact the tissue Potentially damaging dental therapy (see above)
When to Refer the Patient to the Periodontal Specialist59
Although there is no single, specific clinical tipping point that can be used as a guideline for all patients in deciding when to do so, a referral to the periodontist is appropriate when: 59
The______________________ prefers referral
The dentist ____________________ referral is in the best interest of the patient
The dentist determines she/he does not possess sufficient knowledge, skills, and/or
experience to provide the patient with the necessary __________ _________ objectives
The dentist determines that clinical__________________ dictates additional input into the
case
Situations that increase clinical uncertainty include: some medically complex patients; advanced-severe gingival recession defects; multi-tooth involvement; and/or recession risks that cannot be readily modified. 59 According to The Principles and Code of Professional Conduct of the American Dental Association,
patients should receive treatment from those licensed dentists who keep current; have the
appropriate surgical training; and possess the requisite _______________, _____________, and
______________________.6
Every clinician must __________________________ whether they have the knowledge, skills, and
experience to monitor or plan/perform surgery on the patient for the management of gingival
recession defects.59
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References 1. Agudio G, Nieri M, Rotundo R, Franceschi D, Cortellini P, G.P. Pini Prato GP. Periodontal conditions of sites
treated with gingival-augmentation surgery compared to untreated contralateral homologous Sites: A 10- to 27-year long-term study. J Periodontol 2009: 80: 1399-1405.
2. Albandar JM, Kingman A. Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age
and older in the United States, 1988-1994. J Periodontol 1999: 70: 30-43. 3. Allais D, Melsen B. Does labial movement of lower incisors influence the level of the gingival margin? A case-
control study of adult orthodontic patients. Euro J Orthod 2003: 25: 343–352. 4. American Academy of Periodontology. Guidelines for the management of patients with periodontal diseases. J
Periodontol 2006: 77: 1607-1611. 5. American Academy of Periodontology. Parameters of Care. J Periodontol 2000: 71: 847-883. 6. American Dental Association Principles, Code of Professional Conduct & Advisory Opinions
http://www.ada.org/688.aspx (accessed 2/21/2014). 7. American Dental Association. Glossary of Dental Clinical and Administrative Terms. http://www.ada.org/en/publications/cdt/glossary-of-dental-clinical-and-administrative-ter (accessed 8-31-14). 8. Anand PS, Kamath KP, Bansal A, Dwivedi S, Anil S. Comparison of periodontal destruction patterns among
patients with and without the habit of smokeless tobacco use – a retrospective study. J Periodontal Res 2013: 48: 623–631.
9. Andlin-Sobocki A, Bodin L. Dimensional alterations of the gingiva related to changes of facial/lingual tooth
position in permanent anterior teeth of children. A 2-year longitudinal study. J Clin Periodontol 1993: 20: 219-224.
10. Armitage GC. Periodontal diseases: Diagnosis. Ann Periodontol 1996: 1: 37-215. 11. Årtun J, Krogstad O. Periodontal status of mandibular incisors following excessive proclination. A study in
adults with surgically treated mandibular prognathism. Am J Orthod Dentofacial Orthop 1987: 91: 225–232. 12. Baker D L, Seymour G J. The possible pathogenesis of gingival recession. A histological study of induced
recession in the rat. J Clin Periodontol 1976: 3: 208–219. 13. Borgnakke WS, Ylőstalo PV, Taylor GW, Genco RJ. Effect of periodontal disease on diabetes: systematic
review of epidemiologic observational evidence. J Clin Periodontol 2013: 40 (Suppl. 14): S135–S152. 14. Brooks JK, Hooper KA, Reynolds MA. Formation of mucogingival defects associated with intraoral and perioral
piercing. Case Reports. J Am Dent Assoc 2003: 134: 837-843. 15. Campbell A, Moore A, Williams E, Stephens J, Tatakis DN. Tongue piercing: Impact of time and barbell stem
length on lingual gingival recession and tooth chipping. J Periodontol 2002: 73: 289-297. 16. Carr AB, Ebbert J. Interventions for tobacco cessation in the dental setting. Cochrane Database of Systematic
Reviews 2012, Issue 6. Art. No.: CD005084. 17. Chambrone L, Chambrone LA. Gingival recessions caused by lip piercing: Case report. J Can Dent Assoc
2003: 69: 505–8. 18. Chambrone LA, Chambrone L. Subepithelial connective tissue grafts in the treatment of multiple recession-type
defects. J Periodontol 2006: 77: 909-916.
©2015 George K. Merijohn, DDS All rights reserved Page 13
19. Chambrone, L., Faggion, C. M. Jr, Pannuti, C. M. & Chambrone, L. A. Evidence-based periodontal plastic surgery: an assessment of quality of systematic reviews in the treatment of recession-type defects. J Clin Periodontol 2010: 12: 1110–1118.
20. Chambrone L, Preshaw PM, Rosa EF, Heasman PA, Romito GA, Pannuti CM, Tu Y-K. Effects of smoking
cessation on the outcomes of non-surgical periodontal therapy: a systematic review and individual patient data meta-analysis. J Clin Periodontol 2013: 40: 607–615.
21. Christman A, Schrader S, John V, Zunt S, Maupome G, Prakasam S. Designing a safety checklist for dental
implant placement: A Delphi study. J Am Dent Assoc 2014: 145: 131-40.
22. Claffey N, Shanley D. Relationship of gingival thickness and bleeding to loss of probing attachment in shallow sites following nonsurgical periodontal therapy. J Clin Periodontol 1986: 13: 654-657.
23. Cutler CW, Machen RL, Jotwani R, Iacopino AM. Heightened gingival inflammation and attachment loss in type
2 diabetics with hyperlipidemia. J Periodontol 1999: 70:1313-1321. 24. Dilsiz, A, Tugba Aydin T. Self-inflicted gingival injury due to habitual fingernail scratching: A case report with a
1-year follow up. Euro J Dent 2009: 3: 150-154. 25. Djeu G, Hayes C, Zawaideh S. Correlation between mandibular central incisor proclination and gingival
recession during fixed appliance therapy. Angle Orthod 2002: 72: 238–245. 26. Donovan TE, Chee WW. Current concepts in gingival displacement. Dent Clin North Am 2004: 48: 433–444. 27. Donovan TE, Cho GC. Predictable aesthetics with metal-ceramic and all-ceramic crowns: the critical
importance of soft-tissue management. Periodontol 2000 2001: 27: 121–130.
28. Dorfman HS, Kennedy JE, Bird WC. Longitudinal evaluation of free autogenous gingival grafts. J Clin Periodontol 1980: 7: 316-324.
29. Dorfman HS, Kennedy JE, Bird WC. Longitudinal evaluation of free autogenous gingival grafts. A four year
report. J Periodontol 1982: 53: 349-352. 30. Ervasti T, Knuuttila M, Pohjamo L, Haukipuro K.Relation between control of diabetes and gingival bleeding. J
Periodontol 1985: 56:154-157. 31. Freedman AL, Salkin LM, Stein MD, Green K. A 10-year longitudinal study of untreated mucogingival defects. J
Periodontol 1992: 63: 71-72. 32. Freedman AL, Green K, Salkin LM, Stein MD, Mellado JR. An 18-year longitudinal study of untreated
mucogingival defects. J Periodontol 1999: 70: 1174-1176. 33. Fiorini T, Musskopf ML, Oppermann RV, Susin C. Is there a positive effect of smoking cessation on periodontal
health? A systematic review. J Periodontol 2014: 85: 83-91. 34. Gawande A A. The Checklist Manifesto: How to Get Things Right. New York City: Henry Holt and Co.; 2009. 35. Goldberg PV, Higginbottom FL, Wilson TG Jr. Periodontal considerations in restorative and implant therapy.
Periodontology 2000 2001: 25: 100–109. 36. Greggianin BF, Oliveira SC, Haas AN, Oppermann RV. The incidence of gingival fissures associated with
toothbrushing: crossover 28-day randomized trial. J Clin Periodontol 2013: 40: 319–326. 37. Griffin SO, Griffin PM, Swann JL, Zlobin N. Estimating rates of new root caries in older adults. J Dent Res 2004:
83: 634-638.
©2015 George K. Merijohn, DDS All rights reserved Page 14
38. Haffajee AD, Socransky SS. Relationship of cigarette smoking to attachment level profiles. J Clin Periodontol 2001: 28: 283–295.
39. Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat A-HS, Dellinger P, Herbosa T, Joseph S, Kibatala
PL, Lapitan MCM, Merry AF, Moorthy K, Reznick RK, Taylor B, Gawande AA. A surgical safety checklist to reduce morbidity and mortality in a global population . N Engl J Med 2009: 360: 491-499.
40. Holmstrup P. Non-plaque-induced gingival lesions. Ann Periodontol 1999: 4: 20-29. 41. Ishikawa I, McGuire M, Mealey B, Blieden TM, Douglass GL, Halmon WW, Nevins M, Pini Prato GP, Polson
AM, Shallhorn RG, Wennström JL. Consensus Report: Mucogingival deformities and conditions around teeth. Ann Periodontol 1999: 4: 101.
42. Johnson GK, Guthmiller JM. The impact of cigarette smoking on periodontal disease and treatment.
Periodontology 2000 2007: 44: 178–194. 43. Joshipura KJ, Kent RL, DePaola PF. Gingival recession: intra-oral distribution and associated factors. J
Periodontol 1994: 65: 864-871. 44. Joss-Vassalli I, Grebenstein C, Topouzelis N, Sculean A, Katsaros C. Othodontic therapy and gingival
recession: a systematic review. Orthod Craniofac Res 2010: 13: 127–141. 45. Kassab MM, Cohen RE. The etiology and prevalence of gingival recession. J Am Dent Assoc 2003: 134: 220-
225. 46. Kennedy JE, Bird WC, Palcanis KG, Dorfman HS. A longitudinal evaluation of varying widths of attached
gingiva. J Clin Periodontol 1985: 12: 667-675. 47. Khocht A, Simon G, Person P, Denepitiyai JL. Gingival recession in relation to history of hard toothbrush use. J
Periodontol 1993: 64: 900-905. 48. Kisch J, Badersten A, Egelberg J. Longitudinal observation of “unattached,” mobile gingival areas. J Clin
Periodontol 1986: 13: 131-134. 49. Kloukos D, Eliades T, Sculean A, Katsaros C. Indication and timing of soft tissue augmentation at maxillary and
mandibular incisors in orthodontic patients. A systematic review. Euro J Orthod 2014: 36: 442-449. 50. Krejci CB. Self-inflicted gingival injury due to habitual fingernail biting. J Periodontol 2000: 71: 1029-1031. 51. Lang NP, Lőe H. The relationship between the width of keratinized gingiva and gingival health. J Periodontol
1972: 43: 623-627. 52. Lempesi E, Koletsi D, Fleming P, Pandis N. The reporting quality of randomized controlled trials in orthodontics.
J Evid Base Dent Pract 2014: 14: 46-52. 53. Lindhe J, Allen E, Maynard G Jr, Bruno J, Miller PD, Holbrook T, Wennstrőm J, Pini Prato G, Takei H.
Consensus report. Mucogingival Therapy. Ann Periodontol 1996: 1: 702-706. 54. Litonjua LA, Andreana S, Bush PJ, Cohen RE. Toothbrushing and gingival recession. Int Dent J 2003: 53: 67-
72. 55. Lőe H, Ånerud Å, Boysen H. The natural history of periodontal disease in man: prevalence, severity, and extent
of gingival recession. J Periodontol 1992: 63: 489-495. 56. Matas F, Sentis J, Mendieta C. Ten-year longitudinal study of gingival recession in dentists. J Clin Periodontol
2011: 38: 1091–1098.
©2015 George K. Merijohn, DDS All rights reserved Page 15
57. Mealey BL, Moritz AJ. Hormonal influences: effects of diabetes mellitus and endogenous female sex steroid hormones on the periodontium. Periodontol 2000 2003: 32: 59–81.
58. Mealey BL, Oates TW. Diabetes mellitus and periodontal diseases. J Periodontol 2006: 77: 1289-1303. 59. Merijohn, GK. Management and Prevention of Gingival Recession. Periodontol 2000 2015: accepted. 60. Merijohn GK. The evidence-based clinical decision support guide: mucogingival/esthetics. J Evid Base Dent
Pract 2007: 7: 93-101. 61. Merijohn, GK. The Practicing Clinician’s Perspective: Using the EBD Approach and CDS Tools in Private
Practice. J Evid Base Dent Pract 2008: 8:203-205. 62. Merijohn GK. The precautionary context clinical practice model: a means to implement the evidence-based
approach. Interactive learning groups for evidence-based knowledge sharing. J Evid Base Dent Pract 2005: 5:115-24.
63. Merijohn GK, Bader JD, Frantsve-Hawley J, Aravamudhan K. Clinical decision support chairside tools for
evidence-based dental practice. J Evid Base Dent Pract 2008: 8:119-32. 64. Merijohn G, Newman M. The Translational Clinical Practice System: A way to implement the evidence-based
approach in the dental practice. CDA J 2006: 34: 529-539. 65. Miyasato M, Crigger M, Egelberg J. Gingival condition in areas of minimal and appreciable width of keratinized
gingiva. J Clin Periodontol 1977: 4: 200-209. 66. Newman MG. Clinical Decision Support Complements Evidence-Based Decision making in Dental Practice. J
Evid Base Dent Pract 2007: 7: 1-5. 67. Olsson M, Lindhe J. Periodontal characteristics in individuals with varying form of the upper central incisors. J
Clin Periodontol 1991: 18: 78-82. 68. Oshreroff JA, Teich JM, Middleton BF, Steen EB, Wright A, Detmer DE. A Roadmap for National Action on
Clinical Decision Support, June 13, 2006. http://www.amia.org/public-policy/reports-and-fact-sheets/a-roadmap-for-national-action-on-clinical-decision-support (accessed 8-31-14).
69. Palmer RM, Wilson RF, Hasan AS, Scott DA. Mechanisms of action of environmental factors – tobacco
smoking. J Clin Periodontol 2005: 32 (Suppl. 6): 180–195. 70. Papapanou PN. Periodontal diseases: Epidemiology. Ann Periodontol 1996: 1: 1 -36. 71. Pattison GL. Self-inflicted gingival injuries: Literature review and case report. J Periodontol 1983: 54: 299-304. 72. Pinsky HM, Taichman RS, Sarment DP. Adaptation of airline crew resource management principles to
dentistry. J Am Dent Assoc 2010: 141: 1010-1018. 73. Plessas A, Pepelassi E. Dental and periodontal complications of lip and tongue piercing: prevalence and
influencing factors. Australian Dent J 2012: 57: 71–78. 74. Powell RN, McEniery TM. A longitudinal study of isolated recession in the mandibular central incisor region of
children aged 6-8 years. J Clin Periodontol 1982: 9: 357-364. 75. Ramseier CA, Warnakulasuriya S, Needleman IG, Gallagher JE, Lahtinen A, co-authors of the 2nd European
workshop’s position papers. Consensus Report: 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals. Int Dent J 2010: 60: 3-6.
76. Rawal SY, Lewis CJ, Kalmar JR, Tatakis DN. Traumatic lesions of the gingiva: A case series. J Periodontol
2004: 74: 762-769.
©2015 George K. Merijohn, DDS All rights reserved Page 16
77. Renkema AM, Fudalej PS, Renkema AAP, Abbas F, Bronkhorst E, Katsaros C. Gingival labial recessions in orthodontically treated and untreated individuals – a pilot case–control study. J Clin Periodontol 2013: 40: 631–637.
78. Sackett DL, Rosenberg WMC, Muir Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is
and what it isn’t. BMJ 1996: 312:71-2. 79. Sarfati A, Bourgeois D, Katsahian S, Mora F, Bouchard P. Risk assessment for buccal gingival recession
defects in an adult population. J Periodontol 2010: 81: 1419-1425. 80. Semel ME, Resch S, Haynes AB, Funk LM, Bader A, Berry WR, Weiser TG, Gawande AA. Adopting a surgical
safety checklist could save money and improve the quality of care in U.S. hospitals. Health Affairs 2010: 29:1593-1599.
81. Serino G, Wennstrőm J, Lindhe J, Eneroth L: The prevalence and distribution of gingival recession in subjects
with a high standard of oral hygiene. J Clin Periodontol 1994: 21: 57-63. 82. Slutzkey S, Levin L. Gingival recession in young adults: occurrence, severity, and relationship to past
orthodontic treatment and oral piercing. Am J Orthod Dentofacial Orthop 2008: 134: 652–656. 83. Stetler KJ, Bissada NF. Significance of the width of keratinized gingiva on the periodontal status of teeth with
submarginal restorations. J Periodontol 1987: 58: 696-700. 84. Susin C, Haas AN, Oppermann RV, Haugejorden O, Albandar JM. Gingival recession: epidemiology and risk
indicators in a representative urban Brazilian population. J Periodontol 2004: 75: 1377-1386. 85. Thomson, W. M. Orthodontic treatment outcomes in the long term: findings from a longitudinal study of New
Zealanders. The Angle Orthodontist 2002: 72: 449–455. 86. Toker H, Ozdemir H. Gingival recession: epidemiology and risk indicators in a university dental hospital in
Turkey. Int J Dent Hygiene 2009: 7: 115–120. 87. Touyz SW, Liew VP, Tseng P, Frisken K, Williams H, Beumont PJV. Oral and Dental Complications in Dieting
Disorders. Int J Eating Disorders 1993: 14: 341-348. 88. Tugnait A, Clerehugh V. Gingival recession - its significance and management. J Dent 2001: 29: 381-394. 89. Watson PJC. Gingival recession. J Dent 1984: 12: 29-35. 90. Wennstrőm JL. Mucogingival Considerations in Orthodontic Treatment. Semin Orthod 1996: 2: 46-54. 91. Wennstrőm, JL. Mucogingival Therapy. Ann Periodontol 1996: 1: 671-701. 92. World Health Organization. Implementation manual – WHO surgical safety checklist (first edition). WHO Press,
Geneva, Switzerland. 2008. 93. Yared K F, Zenobio E G, Pacheco W. Periodontal status of mandibular central incisors after orthodontic
proclination in adults. Am J Orthod Dentofacial Orthop 2006: 130: 6.e1–e8. 94. Yoneyama T, Okamoto H, Lindhe J, Socransky SS, Haffajee AD. Probing depth, attachment loss and gingival
recession. Findings from a clinical examination in Ushiku, Japan. J Clin Periodontol 1988: 15: 581-591. 95. Zlatarić DK, Čelebić A, Valentić-Peruzović M. The effect of removable partial dentures on periodontal health of
abutment and non-abutment teeth. J Periodontol 2002:
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