Download PDF
CC BY-NC-ND 4.0 · European Journal of General Dentistry 2019; 8(02): 45-50
DOI: 10.4103/ejgd.ejgd_42_19
Original Article

Comparison of miller’s classification of gingival recession defects with mahajan’s classification of gingival recession defect: A reliability study

Ajay Mahajan
Department of Periodontology, Himachal Pradesh Government Dental College and Hospital, Shimla, Himachal Pradesh, India
,
Kanwarjit Singh Asi
Department of Periodontology, Himachal Pradesh Government Dental College and Hospital, Shimla, Himachal Pradesh, India
,
Deepa Rayast
1   Department of Implantology, Himachal Pradesh Government Dental College and Hospital, Shimla, Himachal Pradesh, India
,
Mayum Negi
1   Department of Implantology, Himachal Pradesh Government Dental College and Hospital, Shimla, Himachal Pradesh, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background: Gingival recession is a common periodontal problem encountered in most populations. A number of classification systems are available to classify gingival recession defects (GRDs), but there has been a lack of consensus among the clinicians regarding the choice of classification system to classify GRDs. Recently, Miller’s classification has been criticized owing to its inherent limitations. Mahajan’s classification was proposed to eliminate the drawbacks of Miller’s classification system. To the best of our knowledge, there has been no study testing or comparing the reliability of Miller’s classification; therefore, the present study was done to compare the reliability of Miller’s classification with Mahajan’s classification. Materials and Methods: The sites selected for the study were classified for GRD according to either Miller’s classification or Mahajan’s classification by the two groups of four examiners. All the examiners were calibrated for the two classification systems and classified the selected sites accordingly. Kappa statistics was performed to analyze the intra- and interrater agreement among the four examiners. Results: A total of 609 gingival recession sites in 91 patients (49 males and 42 females) were classified. At the end of the study, Mahajan’s classification had a higher intrarater (κ = 0.93–0.83) and interrater reliability (κ = 0.93) compared to Miller’s classification for GRD for both intrarater (κ = 0.57–0.68) and interrater observations (κ = 0.66), respectively. Conclusions: Miller’s classification system was less reliable than Mahajan’s classification system.

Keywords

Gingival recession - Miller’s classifications - prognosis - reliability - treatment plan

Financial support and sponsorship

Nil.




Publication History

Article published online:
01 November 2021

© 2019. European Journal of General Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 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;75:1377-86.
  • 2 Cairo F, Nieri M, Cincinelli S, Mervelt J, Pagliaro U. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: An explorative and reliability study. J Clin Periodontol 2011;38:661-6.
  • 3 Pihlstrom BL. Periodontal risk assessment, diagnosis and treatment planning. Periodontol 2000 2001;25:37-58.
  • 4 Ozden FO, Özgönenel O, Özden B, Aydogdu A. Diagnosis of periodontal diseases using different classification algorithms: A preliminary study. Niger J Clin Pract 2015;18:416-21.
  • 5 Rotundo R, Mori M, Bonaccini D, Baldi C. Intra- and inter-rater agreement of a new classification system of gingival recession defects. Eur J Oral Implantol 2011;4:127-33.
  • 6 Pini-Prato G, Franceschi D, Cairo F, Nieri M, Rotundo R. Classification of dental surface defects in areas of gingival recession. J Periodontol 2010;81:885-90.
  • 7 Nordland WP, Tarnow DP. A classification system for loss of papillary height. J Periodontol 1998;69:1124-6.
  • 8 Miller PD Jr. A classification of marginal tissue recession. Int J Periodontics Restorative Dent 1985;5:8-13.
  • 9 Pini-Prato G. The Miller classification of gingival recession: Limits and drawbacks. J Clin Periodontol 2011;38:243-5.
  • 10 Mahajan A. Mahajan’s modification of Miller’s classification for gingival recession. Dent Hypotheses 2010;1:45-50.
  • 11 Mahajan A, Kashyap D, Kumar A, Mahajan P. Reliability study of Mahajan’s classification of gingival recession: A pioneer clinical study. J Indian Soc Periodontol 2014;18:38-42.
  • 12 Kahn S, Almeida RA, Dias AT, Rodrigues WJ, Barceleiro MO, Taba M Jr. Clinical considerations on the root coverage of gingival recessions in thin or thick biotype. Int J Periodontics Restorative Dent 2016;36:409-15.
  • 13 De Rouck T, Eghbali R, Collys K, De Bruyn H, Cosyn J. The gingival biotype revisited: Transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J Clin Periodontol 2009;36:428-33.
  • 14 Fischer KR, Künzlberger A, Donos N, Fickl S, Friedmann A. Gingival biotype revisited-novel classification and assessment tool. Clin Oral Investig 2018;22:443-8.
  • 15 Maroso FB, Gaio EJ, Rösing CK, Fernandes MI. Correlation between gingival thickness and gingival recession in humans. Acta Odontol Latinoam 2015;28:162-6.
  • 16 Chambrone L, Faggion CM Jr., Pannuti CM, Chambrone LA. Evidence-based periodontal plastic surgery: An assessment of quality of systematic reviews in the treatment of recession-type defects. J Clin Periodontol 2010;37:1110-8.
  • 17 Chambrone L, Tatakis DN. Periodontal soft tissue root coverage procedures: A systematic review from the AAP regeneration workshop. J Periodontol 2015;86:S8-51.
  • 18 Vincent-Bugnas S, Borie G, Charbit Y. Treatment of multiple maxillary adjacent Class I and II gingival recessions with modified coronally advanced tunnel and a new xenogeneic acellular dermal matrix. J Esthet Restor Dent 2018;30:89-95.
  • 19 Vincent-Bugnas S, Charbit Y, Lamure J, Mahler P, Dard MM. Modified tunnel technique combined with enamel matrix derivative: A minimally invasive treatment for single or multiple Class I recession defects. J Esthet Restor Dent 2015;27:145-54.
  • 20 Mahn DH. A double-layer technique using an acellular dermal matrix for the treatment of Miller Class I and II gingival recession defects: 1-year results of 50 consecutive cases. Int J Periodontics Restorative Dent 2015;35:257-62.
  • 21 Kumar A, Masamatti SS. A new classification system for gingival and palatal recession. J Indian Soc Periodontol 2013;17:175-81.
  • 22 Reddy S, Kaul S, Prasad MG, Agnihotri J, Amudha D, Kambali S. Gingival recession: A proposal for a new classification. Int J Dent Clinics 2012;4:32-6.
  • 23 Zucchelli G, Marzadori M, Mounssif I, Mazzotti C, Stefanini M. Coronally advanced flap + connective tissue graft techniques for the treatment of deep gingival recession in the lower incisors. A controlled randomized clinical trial. J Clin Periodontol 2014;41:806-13.
  • 24 Zucchelli G, Mounssif I, Mazzotti C, Stefanini M, Marzadori M, Petracci E, et al. Coronally advanced flap with and without connective tissue graft for the treatment of multiple gingival recessions: A comparative short- and long-term controlled randomized clinical trial. J Clin Periodontol 2014;41:396-403.
  • 25 Zucchelli G, Mele M, Mazzotti C, Marzadori M, Montebugnoli L, De Sanctis M. Coronally advanced flap with and without vertical releasing incisions for the treatment of multiple gingival recessions: A comparative controlled randomized clinical trial. J Periodontol 2009;80:1083-94.