Assessing risk of gingival recession in adults
Sarfati A, Bourgeois D, Katsahian S, Mora F, Bouchard P. Risk assessment for buccal gingival recession defects in an adult population. J Periodontol 2010;81:1419-25
Gingival recession is common in adults. However, it is not clear how periodontal, systemic, and environmental factors are associated with gingival recession. This cross-sectional study examined some of the risk factors. The data originated in the First National Periodontal and Systemic Examination Survey; 1093 men and 1051 women, aged 35 to 65 years, were selected with a multi-stage stratification method by age, sex, socioeconomic status, and region to represent the total French civilian population. Full-mouth periodontal evaluation, biometric data, body mass index, blood serum glucose concentration, frequency of dental visits, smoking status, and alcohol consumption were all recorded. The extent and the severity of midbuccal recession were the focus of the study and were measured as the number of affected sites and quantified in millimeters. Mesial and distal buccal sites were used for the Miller classifications. Age, sex, alcohol consumption, and diabetic status were set as the categorical variables for the multivariate linear regression models with backward selection. The results demonstrated that 84.6% of the sample had at least 1 recession site. Only 1.8% of the sample had severe recession (≥6 mm). The Miller classes I and II included most of the sample; gingival recession could affect any tooth. Age, sex, plaque index, and tobacco consumption are independent risk factors for the extent and severity of gingival recessions. Furthermore, the number of missing teeth and the gingival bleeding index are related to the severity of gingival defects. Diabetes, increase of body mass index, alcohol intake, and dental visits showed no correlation with gingival recession.
Reviewed by YunYan Tracy Shen
Systematic review of profile change after maxillofacial surgery
Joss CU, Joss-Vassalli IM, Bergé SJ, Kuijpers-Jagtman AM. Soft tissue profile changes after bilateral sagittal split osteotomy for mandibular setback: a systematic review. J Oral Maxillofac Surg 2010;68:2792-801; e-pub, August 2010
The prediction of facial profile changes after maxillofacial surgery is a significant part of treatment planning for surgical orthodontic patients. Since most clinicians use a 2-dimensional approach with lateral cephalograms, the availability of precise research data as a basis for prediction software is critical. This article provides a systematic review of the literature on the soft-tissue changes in patients who underwent bilateral sagittal split osteotomies for mandibular setback. The authors sought to determine the ratio between soft-tissue and hard-tissue movements and illustrate differences in short-term and long-term results. An online search resulted in 766 articles. After assessment and extraction of the articles by 2 observers, 8 articles met the inclusion criteria and were selected. Studies other than human clinical trials, and those with syndromic patients and patients who needed further surgical intervention, or sample sizes less than 10, were excluded. The authors observed that anteroposterior changes in lower lip to mandibular incisor and mentolabial fold to B-point had a 1:1 ratio in both the short and long terms. Soft-tissue pogonion to pogonion exhibited a 1:1 ratio in the short term but was lower in the long term. The response of the upper lip was highly variable when compared with the mandibular incisor, B-point, and pogonion, primarily exhibiting protrusion. Evidence-based conclusions on soft-tissue changes are difficult to draw, and there is a need for well-designed prospective studies with adequate sample sizes and exclusion of additional surgical procedures. Moreover, variability in postsurgical relapse and the presence of bonded brackets are variables that might affect the accuracy of measurements and should be considered in the future.
Reviewed by Christine Kownatzki
Systematic review of profile change after maxillofacial surgery
Joss CU, Joss-Vassalli IM, Bergé SJ, Kuijpers-Jagtman AM. Soft tissue profile changes after bilateral sagittal split osteotomy for mandibular setback: a systematic review. J Oral Maxillofac Surg 2010;68:2792-801; e-pub, August 2010
The prediction of facial profile changes after maxillofacial surgery is a significant part of treatment planning for surgical orthodontic patients. Since most clinicians use a 2-dimensional approach with lateral cephalograms, the availability of precise research data as a basis for prediction software is critical. This article provides a systematic review of the literature on the soft-tissue changes in patients who underwent bilateral sagittal split osteotomies for mandibular setback. The authors sought to determine the ratio between soft-tissue and hard-tissue movements and illustrate differences in short-term and long-term results. An online search resulted in 766 articles. After assessment and extraction of the articles by 2 observers, 8 articles met the inclusion criteria and were selected. Studies other than human clinical trials, and those with syndromic patients and patients who needed further surgical intervention, or sample sizes less than 10, were excluded. The authors observed that anteroposterior changes in lower lip to mandibular incisor and mentolabial fold to B-point had a 1:1 ratio in both the short and long terms. Soft-tissue pogonion to pogonion exhibited a 1:1 ratio in the short term but was lower in the long term. The response of the upper lip was highly variable when compared with the mandibular incisor, B-point, and pogonion, primarily exhibiting protrusion. Evidence-based conclusions on soft-tissue changes are difficult to draw, and there is a need for well-designed prospective studies with adequate sample sizes and exclusion of additional surgical procedures. Moreover, variability in postsurgical relapse and the presence of bonded brackets are variables that might affect the accuracy of measurements and should be considered in the future.
Reviewed by Christine Kownatzki
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