Рецессия десны: распространенность, классификация, факторы риска, методы лечения
https://doi.org/10.59598/ME-2305-6053-2025-115-2-17-28
Аннотация
Рецессия десны является распространенной патологией полости рта. Показатели распространённости варьируются от 15 до 99,7%. Рецессия десны часто приводит к серьезным эстетическим проблемам. Могут также привести к дополнительным жалобам на повышенную чувствительность и образованию пришеечного кариеса. К развитию рецессии десны способствуют множество факторов: вредные привычки, плохая гигиена полости рта, ятрогенные факторы, последствие ортодонтического лечения и т. д.
Лечение рецессии десны следует начинать с устранения этиологических факторов. Тем, не менее при уже сформированном дефекте, данные действия не способны решить проблему. Золотым стандартом в устранении рецессией является хирургическое лечение. Выбор хирургического метода обусловлен количеством дефектов, анатомических условий в полости рта и др.
Об авторах
С. Т. ТулеутаеваКазахстан
100000, г. Караганда, ул. Алалыкина 14
О. А. Понамарева
Казахстан
100000, г. Караганда, ул. Гоголя 40
К. С. Мухтарова
Казахстан
100000, г. Караганда, ул. Алалыкина 14
Ж. Ж. Аширбекова
Казахстан
Жадыра Жанамаевна Аширбекова
100000, г. Караганда, ул. Алалыкина 14
С. А. Гранько
Беларусь
220028, г. Минск, ул. Петруся Бровки 3, к. 3
Д. Ж. Тулеутаев
Казахстан
100000, г. Караганда, ул. Алалыкина 14
М. Р. Айдосов
Казахстан
100000, г. Караганда, ул. Алалыкина 14
Р. М. Ужахова
Казахстан
100000, г. Караганда, ул. Алалыкина 14
Список литературы
1. Pabst A.M., Happe A., Callaway A. In vitro and in vivo characterization of porcine acellular dermal matrix for gingival augmentation procedures. Journal of Periodontal Reseиarch. 2014; 49 (3): 371-381.
2. Ahmedbeyli C., Dirikan Ipçi S., Cakar G., Yılmaz S., Chambrone L. Coronally Advanced Flap and Envelope Type of Flap plus Acellular Dermal Matrix Graft for the Treatment of Thin Phenotype Multiple Recession Defects. A Randomized Clinical Trial. J. Clin. Periodontol. 2019; 46: 1024-1029.
3. Albandar J.M., 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
4. Azaripour A., Kissinger M., Farina V.S. Root coverage with connective tissue graft associated with coronally advanced flap or tunnel technique: a randomized, doubleblind, mono-centre clinical trial. J. Clin Periodontol. 2016; 43: 1142-1150.
5. Schmitt C.M., Matta R.E., Moest T. Soft tissue volume alterations after connective tissue grafting at teeth: the subepithelial autologous connective tissue graft versus a porcine collagen matrix a pre-clinical volumetric analysis. Journal of Clinical Periodontology. 2016; 43 (7): 609-617.
6. Cairo F., Nieri M., Cincinelli S., Mervelt J., Pagliaro U. The interproximal clinical attachment level tоo classify gingival recessions and predict root coverage outcomes: an explorative and reliability study. J. Clin Periodontol. 2011; 38 (7): 661-666. https://doi.org/10.1111/j.1600051X.2011.01732.x
7. Cairo F., Nieri, M., Pagliaro U. Efficacy of Periodontal Plastic Surgery Procedures in the Treatment of Localized Facial Gingival Recessions. A Systematic Review. J. Clin. Periodontol. 2014; 41: S44-S62.
8. Chambrone L., Salinas Ortega M.A., Sukekava F., Rotundo R., Kalemaj Z., Buti J., Pini Prato G.P. Root Coverage Procedures for Treating Localised and Multiple Recession-Type Defects. Cochrane Database Syst. Rev. 2018; 10: CD007161.
9. Cortellini P., Bissada N.F. Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. J. Periodontol. 2018; 89: S204-S213. https://doi.org/10.1002/JPER.16-0671
10. Wainwright D. J. Use of an acellular allograft dermal matrix (AlloDerm) in the management of full-thickness burns. Burns. 1995; 21 (4): 243-248.
11. Rothamel D., Benner M., Fienitz T. Biodegradation pattern and tissue integration of native and cross-linked porcine collagen soft tissue augmentation matrices an experimental study in the rat. Head & Face Medicine. 2014; 10: 10.
12. Dadlani S. Porcine Acellular Dermal Matrix: An Alternative to Connective Tissue Graft-A Narrative Review. Int. J. Dent. 2021; 2021: 1652032. https://doi.org/10.1155/2021/1652032
13. Donaldson D. The etiology of gingival recession associated with temporary crowns. J. Periodontol. 1974; 45: 468-471.
14. El Kholti W., Boubdir S., Al Jalil Z., Rhalimi L., Chemlali S., Mound A., Aboussaouira T., Kissa J. Prevalence and risk indicators of buccal gingival recessions in a Moroccan periodontitis patients: A retrospective study. Saudi Dent J. 2024; 36 (1): 117-122. https://doi.org/10.1016/j.sdentj.2023.10.008
15. Enrile de Rojas F.J., Ventura de la Torre J., Romero Griñolo J.M. Long-term outcome of implants exhibiting buccal soft tissue dehiscence in the esthetic zone. J. Esthet. Restor. Dent. 2024; 36 (4): 539-547. https://doi.org/10.1111/jerd.13141
16. Rios F.S., Costa R.S.A., Moura M.S., Jardim J.J., Maltz M., Haas A.N. Estimates and multivariable risk assessment of gingival recession in the population of adults from Porto Alegre, Brazil. J. Clin. Periodontol. 2014; 41: 1098-1107. https://doi.org/10.1111/jcpe.12303
17. Fragkioudakis I., Tassou D., Sideri M., Vouros I., 2021. Prevalence and clinical characteristics of gingival recession in Greek young adults: A cross-sectional study. Clin. Exp. Dent. Res. 2021; 7(5): 672-678. https://doi.org/10.1002/cre2.427
18. Graziani F., Gennai S., Roldán S., Discepoli N., Buti J., Madianos P., Herrera D. Efficacy of Periodontal Plastic Procedures in the Treatment of Multiple Gingival Recessions. J. Clin. Periodontol. 2014; 41: S63-S76.
19. Gürlek Ö., Gümüş P., Nizam N., Buduneli N. Coronally advanced flap with connective tissue graft or xenogeneic acellular dermal matrix in the treatment of multiple gingival recessions: A split-mouth randomized clinical trial. J. Esthet. Restor. Dent. 2020; 32(4): 380-388. https://doi.org/10.1111/jerd.12547
20. Johal A., Katsaros C., Kiliardis S., Leito P., Rosa M., Sculean A. State of the science on controversial topics: orthodontic therapy and gingival recession (a report of the Angle Society of Europe 2013 meeting). Prog. Orthod. 2013; 14: 16. https://doi.org/10.1186/2196-1042-14-16
21. Junqueira L., Carneiro J. Connective tissue. In Basic Histology: Text & Atlas. New York; 2005: 618.
22. Kassab M.M., Cohen R.E. The etiology and prevalence of gingival recession. J. Am. Dent. Assoc. 2003; 134 (2): 220-225. https://doi.org/10.14219/jada.archive.2003.0137
23. Kim D.M., Neiva R. Periodontal soft tissue non-root coverage procedures: a systematic review from the AAP Regeneration Workshop. J. Periodontol. 2015; 86: 56-72.
24. Koke U., Sander C., Heinecke A., Müller H.P. A possible influence of gingival dimensions on attachment loss and gingival recession following placement of artificial crowns. Int. J. Periodontics Restorative Dent. 2003; 23: 439-445
25. Kumar A., Masamatti S.S. A new classification system for gingival and palatal recession. J. Indian. Soc. Periodontol. 2013; 17 (2): 175-181. https://doi.org/10.4103/0972-124X.113065
26. Aguirre-Zorzano L.A., Garc´ıa-De La Fuente A.M., Estefan´ıa-Fresco R., Marichalar-Mend´ıa X. Complications of harvesting a connective tissue graft from the palate. a retrospective study and description of a new technique. Journal of Clinical and Experimental Dentistry. 2017; 9 (12): e1439-e1445
27. Livestock Data For Decisions. https://www.livestockdata.org/dataobject/livestock-population-trends 10.12.2022г.
28. Loe H., Anerud A., Boysen H. The natural history of periodontal disease in man: Prevalence, severity and extent of gingival recession. J. Periodontal. 1992; 63: 489495
29. Cie´slik-Wegemund M., Wierucka-Młynarczyk B., Tanasiewicz M., Gilowski Ł. Tunnel technique with collagen matrix compared with connective tissue graft for treatment of periodontal recession: a randomized clinical trial. Journal of Periodontology. 2016; 87 (12): 1436-1443.
30. Mamedov A.A., Harke V.V., Sedel’nikova V.V. Planning of orthodontic treatment of patients with a thin periodontal biotype. Russian Stomatology. 2016; 9 (1): 74-75.
31. Manchala S.R., Vandana K.L., Mandalapu N.B., Mannem S., Dwarakanath C.D. Epidemiology of gingival recession and risk indicators in dental hospital population of Bhimavaram. J. Int. Soc. Prevent. Communit. Dent. 2012; (2): 69-74.
32. Mascardo K.C., Tomack J., Chen C.Y., Mancini L., Kim D.M., Friedland B., Barootchi S., Tavelli L. Risk indicators for gingival recession in the esthetic zone: A cross-sectional clinical, tomographic, and ultrasonographic study. J. Periodontol. 2024; 95 (5): 432-443. https://doi.org/10.1002/JPER.23-0357
33. Matas F., Sentís J., Mendieta C. Ten-year longitudinal study of gingival recession in dentists. J. Clin. Periodontol. 2011; 38 (12): 1091-1098.
34. Miller P.D. A classification of marginal tissue recession. Int. J. Periodontics Restorative Dent. 1985; 5: 8-13.
35. Ministry of Justice of the Republic of Kazakhstan. Patent №31456 «Biological wound coating» dated 30.05.2014.
36. Müller H.P., Stadermann S., Heinecke A. Gingival recession in smokers and non-smokers with minimal periodontal disease. J. Clin. Periodontol. 2002; 29: 129-136.
37. Nu´n˜ez J., Caffesse R., Vignoletti F., Guerra F., San Roman F., Sanz M. Clinical and histological evaluation of an acellular dermal matrix allograft in combination with the coronally advanced flap in the treatment of miller class I recession defects: an experimental study in the mini-pig. Journal of Clinical Periodontology. 2009; 36: 523-531.
38. G¨urlek O., G¨um¨us P., Nizam N., Buduneli N. «Coronally» advanced flap with connective tissue graft or xenogeneic acellular dermal matrix in the treatment of multiple gingival recessions: a split-mouth randomized clinical trial. Journal of Esthetic and Restorative Dentistry. 2020; 32 (4): 380-388.
39. Ozenci I., Ipci S.D., Cakar G., Yilmaz S. Tunnel Technique versus Coronally Advanced Flap with Acellular Dermal Matrix Graft in the Treatment of Multiple Gingival Recessions. J. Clin. Periodontol. 2015; 42: 1135-1142.
40. Parween S., George J. P., Prabhuji M. Treatment of Multiple Mandibular Gingival Recession Defects Using MCAT Technique and SCTG With and Without RhPDGF-BB: A Randomized Controlled Clinical Trial. Int. J. Periodontics Restor. Dent. 2020; 40: e43-e51.
41. Pietruska M., Skurska A., Podlewski Ł., Milewski R., Pietruski J. Clinical evaluation of Miller class I and II recessions treatment with the use of modified coronally advanced tunnel technique with either collagen matrix or subepithelial connective tissue graft: A randomized clinical study. J. Clin. Periodontol. 2019; 46 (1): 86-95. https://doi.org/10.1111/jcpe.13031. Epub 2018 Dec 18. PMID: 30362599
42. Pini-Prato G. The Miller classification of gingival recession: limits and drawbacks. J. Clin. Periodontol. 2011; 38: 243-245.
43. Burkhardt R., Hammerle C.H., Lang N.P. «Research» group on oral soft tissue biology & wound healing. self-reported pain perception of patients after mucosal graft harvesting in the palatal area. Journal of Clinical Periodontology. 2015; 42 (3): 281-287.
44. Cosgarea R., Miron R., Bora R., Rosu A., Buduru S., Sculean A. Long-term results after treatment of multiple adjacent gingival recessions with the modified coronally advanced tunnel and a porcine acellular dermal matrix. Quintessence International. 2021; 52 (1): 32-44.
45. Maluta R., Monteiro M. F., Peruzzo D. C., Joly J. C. Root coverage of multiple gingival recessions treated with coronally advanced flap associated with xenogeneic acellular dermal matrix or connective tissue graft: a 6-month split-mouth controlled and randomized clinical trial. Clinical Oral Investigations. 2021; 25 (10): 5765-5773. https://doi.org/10.1007/s00784-021-03879-8
46. Rakasevic D.L., Milinkovic I.Z., Jankovic S.M., Soldatovic I.A., Aleksic Z.M., Nikolic-Jakoba N.S. The use of collagen porcine dermal matrix and connective tissue graft with modified coronally advanced tunnel technique in the treatment of multiple adjacent type I gingival recessions: A randomized, controlled clinical trial. J. Esthet. Restor. Dent. 2020; 32 (7): 681-690. https://doi.org/10.1111/jerd.12624
47. Romandini M., Soldini M.C., Montero E., Sanz M. Epidemiology of mid-buccal gingival recessions in NHANES according to the 2018 World Workshop Classification System. J. Clin. Periodontol. 2020; 47: 1180-1190.
48. Mythri S., Arunkumar S.M., Hegde S., Rajesh S.K., Munaz M., Ashwin D. Etiology and occurrence of gingival recession An epidemiological study. J. Indian Soc. Periodontol. 2015; 19 (6): 671-675. https://doi.org/10.4103/0972-124X.156881
49. Salhi L., Lecloux G., Seidel L. Coronally advanced flap versus the pouch technique combined with a connective tissue graft to treat Miller’s class I gingival recession: a randomized controlled trial. J. Clin. Periodontol. 2014; 41: 387-395.
50. Scheyer E.T., Sanz M., Dibart S., Greenwell H., John V., Kim D.M. Periodontal soft tissue non-root coverage procedures: a consensus report from the AAP Regeneration Workshop. J. Periodontol. 2015; 86: 73-76.
51. Slutzkey S., Levin L. Gingival recession in young adults: occurrence, severity, and relationship to past orthodontic treatment and oral piercing. Am. J. Orthodont. Dentofac. Orthoped. 2008; 134 (5): 652-656.
52. Snyder D.L., Sullivan N., Schoelles K.M. Skin substitutes for treating chronicwounds. Technology Assessment Report. ECRI Institute Evidence-based 80 Practice-Center (EPC); 2012: 290.
53. Stefanini M., Marzadori M., Aroca S., Felice P., Sangiorgi M., Zucchelli G. Decision Making in Root-Coverage Procedures for the Esthetic Outcome. Periodontology. 2000; 77: 54-64.
54. Susin C., Haas A.N., Oppermann R.V., Haugejorden O., Albandar J.M. Gingival recession: epidemiology and risk indicators in a representative urban Brazilian population. J. Periodontol. 2004; 75: 1377-1386.
55. Tavelli L., Barootchi S., Nguyen T.V.N., Tattan M., Ravidà A., Wang H.L. Efficacy of tunnel technique in the treatment of localized and multiple gingival recessions: A systematic review and meta-analysis. J. Periodontol. 2018; 89 (9): 1075-1090. https://doi.org/10.1002/JPER.18-0066
56. Teixeira D.N.R., Zeola L.F., Machado A.C. Relationship between noncarious cervical lesions, cervical dentin hypersensitivity, gingival recession, and associated risk factors: a cross-sectional study. J. Dent. 2018; 76: 93-97.
57. Thoma D.S., Jung R.E., Schneider D., Cochran D.L., Ender A., Jones A.A., Hammerle C.H. Soft tissue volume augmentation by the use of collagen-based matrices: A volumetric analysis. Journal of Clinical Periodontology. 2010; 37: 659-666. https://doi.org/10.1111/cpe.2010.37.issue-7
58. Thoma D.S., Villar C.C., Cochran D.L., Hammerle C.H., Jung R.E. Tissue integration of collagen-based matrices: An experimental study in mice. Clinical Oral Implants Research. 2012; 23: 1333-1339. https://doi.org/10.1111/clr.2012.23.issue-12
59. Toker H., Ozdemir H. Gingival recession: epidemiology and risk indicators in a university dental hospital in Turkey. Int. J. Dent. Hyg. 2009; 7 (2): 115-120.
60. Toledano-Osorio M., Muñoz-Soto E., Toledano M., Vallecillo-Rivas M., Vallecillo C., Ramos-García P., Osorio R. Treating Gingival Recessions Using Coronally Advanced Flap or Tunnel Techniques with Autografts or Polymeric Substitutes: A Systematic Review and Meta-Analysis. Polymers. 2022; 14: 1453. https://doi.org/10.3390/polym14071453
61. Tonetti M.S., Cortellini P., Pellegrini G., Nieri M., Bonaccini D., Allegri M., Bouchard P., Cairo F., Conforti G., Fourmousis I., Graziani F., Guerrero A., Halben J., Malet J., Rasperini G., Topoll H., Wachtel H., Wallkamm B., Zabalegui I., Zuhr O. Xenogenic collagen matrix or autologous connective tissue graft as adjunct to coronally advanced flaps for coverage of multiple adjacent gingival recession: Randomized trial assessing non-inferiority in root coverage and superiority in oral health-related quality of life. J. Clin. Periodontol. 2018; 45 (1): 78-88. https://doi.org/10.1111/jcpe.12834
62. Tözüm T.F., Keçeli H.G., Güncü G.N., Hatipo ˘glu H., Sengün D. Treatment of Gingival Recession: Comparison of Two Techniques of Subepithelial Connective Tissue Graft. J. Periodontol. 2005; 76: 1842-1848.
63. Tugnait A., Clerehugh V. Gingival recession—its significance and management. J. Dent. 2001; 29: 381-394.
64. Vignoletti F., Di Martino M., Clementini, M., Di Domenico, G.L., de Sanctis, M., 2020. Prevalence and risk indicators of gingival recessions in an Italian school of dentistry and dental hygiene: a cross-sectional study. Clin. Oral Invest. 24, 991-1000.
65. Yadav V.S., Gumber B., Makker K., Gupta V., Tewari N., Khanduja P., Yadav R. Global prevalence of gingival recession: A systematic review and meta-analysis. Oral. Dis.; 29 (8): 2993-3002. doi: 10.1111/odi.14289
66. Vincent-Bugnas S., Laurent J., Naman E., Charbit M., Borie G. Treatment of multiple gingival recessions with xenogeneic acellular dermal matrix compared to connective tissue graft: a randomized split-mouth clinical trial. J. Periodontal. Implant Sci. 2021; 51 (2): 77-87. https://doi.org/10.5051/jpis.2002400120
67. Wennström J.L., Lindhe J., Sinclair F., Thilander B. Some periodontal tissue reactions to orthodontic tooth movement in monkeys. J. Clin. Periodontol. 1987; 14: 121129.
68. 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.
69. Zawawi K.H., Al-Zahrani M.S. Gingival biotype in relation to incisors’ inclination and position. Saudi. Med. J. 2014; 35: 1378-1383.
70. Zucchelli G., De Sanctis M. () Modifed two-stage procedures for the treatment of gingival recession. Eur J E Zucchelli, G.; De Sanctis, M. Treatment of Multiple Recession-Type Defects in Patients with Esthetic Demands. J. Periodontol. 2013; 71: 1506-1514.
71. Zucchelli G.; De Sanctis, M. The Coronally Advanced Flap for the Treatment of Multiple Recession Defects: A Modified Surgical Approach for the Upper Anterior Teeth. J. Int. Acad. Periodontol. 2007; 9: 96-103.
72. Zuhr O., Akakpo D., Eickholz P., Vach K., Hürzeler M.B., Petsos H. Research Group for Oral Soft Tissue Biology & Wound Healing. Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivate for root coverage: 5-year results of an RCT using 3D digital measurement technology for volumetric comparison of soft tissue changes. J. Clin. Periodontol. 2021; 48 (7): 949-961. https://doi.org/10.1111/jcpe.13470
73. Zuhr O., Rebele S.F., Vach K., Petsos H., Hürzeler M.B. Research Group for Oral Soft Tissue Biology & Wound Healing Tunnel Technique with Connective Tissue Graft versus Coronally Advanced Flap with Enamel Matrix Derivate for Root Coverage: 2-Year Results of an RCT Using 3D Digital Measuring for Volumetric Comparison of Gingival Dimensions. J. Clin. Periodontol. 2020; 47: 11441158.
74. Zweers J., Thomas R.Z., Slot D.E., Weisgold A.S., Van der Weijden F. G. Characteristics of periodontal biotype, its dimensions, associations and prevalence, a systematic review. J. Clin. Periodontol. 2014; 41: 958-971.
Рецензия
Для цитирования:
Тулеутаева С.Т., Понамарева О.А., Мухтарова К.С., Аширбекова Ж.Ж., Гранько С.А., Тулеутаев Д.Ж., Айдосов М.Р., Ужахова Р.М. Рецессия десны: распространенность, классификация, факторы риска, методы лечения. Медицина и экология. 2025;(2):17-28. https://doi.org/10.59598/ME-2305-6053-2025-115-2-17-28
For citation:
Tuleutayeva S.T., Ponamareva O.A., Mukhtarova K.S., Ashirbekova Zh.Zh., Granko S.A., Tuleutayev D.Zh., Aidosov M.R., Uzhakhova R.M. GINGIVAL RECESSION: PREVALENCE, CLASSFICATION, RISK FACTORS, TREATMENT METHODS. Medicine and ecology. 2025;(2):17-28. (In Russ.) https://doi.org/10.59598/ME-2305-6053-2025-115-2-17-28