Successful Regenerative Therapy of Periodontal Defects Associated With Tongue Piercing: A Clinical Report.

Oral piercing habits are associated with various degrees of complications. Tongue piercing increases the risk of gingival recession and infrabony defects, subsequently leading to localized periodontitis. In the case presented, the patient had persistent swelling and suppuration around her mandibular anterior teeth attributed to tongue piercing jewelry that was placed approximately 12 years prior. Intraoral examinations revealed a localized deep pocket, purulent discharge, swelling, plaque accumulation, bleeding on probing, gingival recession, and teeth mobility. The patient was diagnosed with localized stage III, grade C periodontitis. Following full-mouth debridement and the placement of an extracoronal lingual splint, minimally invasive, papillae-sparing incisions were made, and regenerative therapy with bone allograft and collagen membrane was used to manage the infrabony defects. During the 18-month postoperative follow-up, complete soft-tissue healing was observed along with a significant reduction in pocket depth and the absence of bleeding on probing or suppuration. Radiographic evaluation showed evidence of bone fill. The reported case demonstrates how careful diagnosis and treatment planning are crucial for managing different periodontal defects and emphasizes the importance of proficient periodontal management, which can save teeth that would otherwise be extracted and replaced with implant therapy or fixed bridgework.

Influence of fixed orthodontic steel retainers on gingival health and recessions of mandibular anterior teeth in an intact periodontium - a randomized, clinical controlled trial.

OBJECTIVE: Aim of this randomized clinical controlled trial was to evaluate the influence of fixed orthodontic steel retainers on gingival health and recessions of mandibular anterior teeth. MATERIALS AND METHODS: After end of the orthodontic treatment, patients were randomly assigned into the test (fixed steel retainer) or control group (modified removable vacuum-formed retainer). Periodontal parameters (periodontal probing depth: PPD; recession: REC; bleeding on probing: BOP) as well as plaque and gingival index were assessed on mandibular anterior teeth directly before attaching/handing over the retainer (baseline: BL), 6 and 12 months after orthodontic treatment. RESULTS: 37 patients (test: n = 15, mean age: 16.1±4.2 years; control: n = 17, mean age: 17.1±5.4 years) completed the study. REC and PPD failed to show significant pairwise differences. The number of patients showing gingival health in the area of the mandibular anterior teeth (test: BL n = 10, 6 months n = 9, 12 months n = 11; control: BL n = 10, 6 months n = 16, 12 months n = 15) revealed a significant difference for the intra-group comparison between BL and 6 months in the control group (p = 0.043). The inter-group comparisons failed to show significant differences. CONCLUSION: Young orthodontically treated patients with fixed steel retainers show in 73.3% healthy gingival conditions after one year which are comparable to the control group (88.2%). Gingival recessions were in a clinically non-relevant range at any time of the examination. CLINICAL TRIAL NUMBER: DRKS00016710.

To intrude or not to intrude? A systematic review of the controversy surrounding orthodontic intrusion on reduced periodontium.

OBJECTIVE: The main objective of this review was to evaluate the effects of orthodontic intrusion on patients with reduced periodontium. Additionally, this review aims to explore the potential for attachment gain and tissue regeneration in these patients and identify optimal therapeutic conditions to mitigate any negative effects of intrusion. METHODS: A systematic review was conducted according to the PRISMA 2020 statement. Duplicate electronic searches of the PubMed, Cochrane, EMC Premium, and Science Direct databases were performed by two independent reviewers. Data extraction and quality assessments, including risk of bias evaluation using the Cochrane and ROBINS-I tools were conducted. RESULTS: From an initial pool of 418 articles, 29 were selected after title and abstract screening for full-text review. Following thorough full-text reading, 15 studies were ultimately included in the analysis. The total number of patients included in the studies is 528, who underwent orthodontic intrusion on reduced periodontium. Studies indicated a decrease in periodontal pocket depth and an increase in clinical attachment with ortho-periodontal treatment. Alveolar bone level outcomes varied, showing both increases and losses. Authors generally observed improved papillary regeneration and reduced gingival recessions. CONCLUSION: Clinical studies involving combined ortho-periodontal treatment showed that orthodontic intrusion on a reduced but healthy periodontium can be considered a beneficial treatment for the periodontium, provided that potential adverse effects are carefully monitored.

Long-term radiographic and periodontal evaluations of the bone-grafted alveolar cleft region in young adults born with a UCLP.

BACKGROUND: Studies addressing the periodontal health of the teeth surrounding the bone-grafted cleft in patients born with unilateral cleft lip and palate disagree on whether periodontal health is compromised. OBJECTIVES: To determine periodontal health differences between the cleft and the non-cleft sides nearly a decade after secondary alveolar bone grafting. METHODS: This prospective, controlled (split-mouth design) study comprised an intraoral apical radiographic and a periodontal examination of 40 consecutive patients from one centre (n = 26 males) who had undergone bone grafting at mean age of 10.2 years (±1.6). Probing pocket depth, gingival index, gingival recession, and radiographic bone support were assessed. RESULTS: No significant difference occurred in probing pocket depth between teeth at cleft and non-cleft sites (OR 1.8, P = .488). Gingival recession was present at 6.6% of all examined sites on the cleft side and at 1.7% on the non-cleft side (OR 17.3, P < .001). Gingival recession occurred most often on the buccal and disto-buccal surfaces of the central incisor on the cleft side. The gingival index was significantly higher on the cleft side (OR 8.0, P < .001). The Bergland index was I or II in most patients (87%). LIMITATIONS: Recruitment of eligible patients was lengthy. CONCLUSION: The teeth on the cleft side had high levels of gingival inflammation. Few pathological gingival pockets, however, were found. Shallow gingival recessions frequently occurred around the central incisor on the cleft side. Teeth in the bone-grafted cleft region generally had good bone support.

Impact of oral piercings on periodontal health - A systematic review.

AIM: Evidence on the impact of oral piercings on periodontal conditions is scarce. Thus, the aim of this systematic review was to evaluate the influence of oral piercings on periodontal health. MATERIALS AND METHODS: A systematic literature search was performed for studies published by 6 June 2023, using three electronic databases and a hand search. Clinical trials including ≥10 patients wearing ≥1 oral piercing and presenting data on probing pocket depths (PPDs) were considered. Primary outcomes were PPD, and secondary outcomes included clinical attachment loss (CAL), gingival recession, bleeding on probing (BOP), and plaque score (PI). A synthesis of results, using a vote-counting method, was applied. RESULTS: From 131 titles identified, eight studies, published between 2007 and 2022, were included. Out of these were six cross-sectional studies and two case series. A total of 236 lip piercings and 236 tongue piercings in overall 408 patients were analyzed. In patients with tongue piercings, teeth adjacent to the piercing showed increased PPD (3 of 5 studies), more CAL (3 of 4 studies), more gingival recessions (4 of 4 studies) and a higher BOP (2 of 3 studies) compared with control teeth. In patients with lip piercings, teeth adjacent to the piercing demonstrated more gingival recessions (3 of 4 studies) compared with control teeth. Time since piercing placement was associated with localized periodontal destruction in patients with tongue and/or lip piercings (4 of 7 studies). CONCLUSIONS: The available evidence from eight studies suggests negative effects of tongue piercings on several periodontal health parameters of adjacent teeth, while gingival recessions were frequently detected in patients with lip piercings.

Oral complications associated with metal ion release from oral piercings: a systematic review.

PURPOSE: This systematic review explored dental complications associated with metal ion release from oral piercings using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. METHODS: Item retrieval from October 2022 to December 2022 from databases, such as Cochrane Central Register of Controlled Trials, Medline, PubMed, Embase, Scopus and Web of Science, using predefined search terms was undertaken by two independent reviewers. Data were extracted and risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. From 1509 identified studies, 25 were included for analysis. RESULTS: Of the 25 studies, 20 included both clinical examination and questionnaire-based data. The remaining five studies were deemed low quality based on the Joanna Briggs Institute criteria. The average time piercings were worn ranged between 5 and 48 months. Most studies did not investigate complications from metal ion release. Only two studies examined the direct effects of metal ion release and showed that metal ions may cause hypersensitivity reactions and mucosal changes. Other soft tissue complications were reported, with gingival recession noted in 16 out of 25 studies, especially due to lip piercings. Studies reporting other complications were as follows: swelling (9), pain (8), infection (6), bleeding (6), inflammation (5), alterations to speech, eating and/or swallowing (5), changes to taste or metallic taste (5), and mucosal changes (4). Ten studies reported tooth chipping from tongue piercings. CONCLUSION: Oral piercings leach metal ions into surrounding tissues which may cause local mucosal changes. Furthermore, oral piercings cause damage to both soft and hard oral tissues, particularly gingival recession for lip piercings and tooth chipping for tongue piercings. Thus, to prevent such adverse injuries, dental professionals should discourage patients against oral piercings.

Risk factors for gingival recessions after orthodontic treatment: a systematic review.

BACKGROUND/OBJECTIVES: To systematically review the available evidence concerning the risk factors for gingival recessions (GR) after orthodontic treatment (OT). DATA COLLECTION AND ANALYSIS: Data was obtained and collected by systematically searching 3 data bases: Pubmed, EMBASE, and Web of Science until 20 April 2023. Controlled trials, cohort, case-control or cross-sectional studies describing GR or clinical crown height (CCH) after OT were included. The risk of bias in the selected studies was evaluated with the methodological index for non-randomized studies. RESULTS: Forty-eight articles were included, investigating the following six risk factors for GR: 1. OT (n = 21), 2. Type of orthodontic intervention (n = 32), 3. Patient's baseline occlusal and skeletal characteristics (n = 14), 4. Mucogingival characteristics (n = 10), 5. Oral hygiene (n = 9), and 6. Others (n = 12). Significantly higher prevalence, severity and extent of GR were found in orthodontic patients by 10/15, 4/10, and 2/2 articles respectively. 10/16 articles reported significantly more GR and increased CCH in patients where orthodontic incisor proclination was performed. The evidence surrounding maxillary expansion and orthodontic retention was too heterogeneous to allow for? definitive conclusions. Pre-treatment angle classification, ANB, overjet, overbite, arch width and mandibular divergence were found not to be associated with GR (9/14), while pre-treatment crossbite, symphysis height and width were (5/7 studies). A thin gingival biotype, presence of previous GR, baseline width of keratinized gingiva and facial gingival margin thickness were correlated with increased risk of GR after OT by nine articles, while pocket depth was not. Oral hygiene, sex, treatment duration, and oral piercings were found not to be linked with GR in orthodontic patients, while GR was reported to increase with age in orthodontic patients by 50 per cent of the articles investigating this factor. The mean risk of bias for comparative and not comparative studies was 14.17/24 and 9.12/16. LIMITATIONS: The selected studies were quite heterogeneous regarding study settings, variables reported and included very limited sample sizes. CONCLUSION: Although studies regarding the risk factors for GR are relatively abundant, they are very heterogeneous concerning design, studied factors, methodology and reporting, which often leads to contradictory results. Uniform reporting guidelines are urgently needed for future research. PROSPERO REGISTRATION: CRD42020181661. FUNDING: This research received no funding.

The effect of the interproximal creeping attachment in aesthetic site after root coverage surgery with VISTA technique - A case report.

Gingival recession is a common manifestation in most populations. The mechanism by which gingival recession occurs is not well understood, but it seems to be complex and multifactorial. The main etiological factors are the accumulation of dental plaque biofilm with the resulting inflammatory periodontal diseases and mechanical trauma due to faulty oral hygiene techniques, especially in thin biotypes. This case report describes the treatment of a vestibular recession associated with interdental bone loss, with the VISTA technique associated with a connective tissue graft. The case was evaluated at 3, 9 months and 48 months after the surgery clinically complete root coverage and increased thickness of keratinized tissue were achieved, and the interdental papilla was augmented improving the soft tissue quality for future orthodontic treatment. VISTA technique associated with a connective tissue graft to reconstruct vertically papilla is a promising alternative for minimally invasive treatment and stable after 4 years.

Hard and Soft Tissue Alterations After Immediate Implant Placement and Provisionalization with Customized Definite Abutment in Esthetic Zone: A Retrospective Study.

PURPOSE: To evaluate the hard and soft tissue alterations of immediate implant placement and provisionalization with customized definitive abutments in the esthetic zone. MATERIALS AND METHODS: Single unsalvageable maxillary anterior teeth were replaced with immediate implant placement and provisionalization with definitive abutments in 22 participants. Digital impressions and CBCT images were obtained presurgery, immediately after surgery, and 6 months after surgery. Horizontal and vertical buccal bone changes in thickness and height (HBBT, VBBH), vertical changes for the gingiva margin, mesial and distal papilla height, and horizontal changes for soft tissue (HCST) were analyzed using a 3D superimposition method. RESULTS: Twenty-two participants completed the study. No implant failed, and there were no mechanical or biologic complications for any patients. At 6 months after surgery, the mean HBBT changes at 0, 1, 2, 3, 5, 7, 10, 11.5, and 13 mm were -0.92 ± 0.73, -0.83 ± 0.53, -0.82 ± 0.49, -0.70 ± 0.64, -0.65 ± 0.47, -0.50 ± 0.51, -0.15 ± 0.45, -0.10 ± 0.57, and -0.00 ± 0.64 mm, respectively. The mean VBBH change was -0.61 ± 0.76 mm. The mean HCSTs at -3, -2, -1, 0, 1, 2, and 3 mm sub- and supra-implant shoulder were -0.65 ± 0.54, -0.70 ± 0.56, -0.65 ± 0.51, -0.61 ± 0.56, -0.47 ± 0.54, -0.47 ± 0.59, and -0.46 ± 0.59 mm, respectively. The mean gingiva margin recession was -0.38 ± 0.67 mm. The mean mesial papilla height recession was -0.03 ± 0.50 mm. The mean distal papilla height recession was -0.12 ± 0.56 mm. CONCLUSION: The definitive abutment used with immediate implant placement and provisionalization could potentially maintain the buccal bone thickness and height. For the facial soft tissue, it also benefited the maintenance of the midfacial gingival margin position and papilla height during the 6-month follow-up. Int J Oral Maxillofac Implants 2023;38:479-488. doi: 10.11607/jomi.9914.

Patterns and predictors of periodontal disease and tooth loss among users of smokeless tobacco.

BACKGROUND: Smokeless tobacco (SLT) products of several different types are widely used in several South Asian countries including Pakistan. These products are consumed in different forms and with different names. The study aims to determine adverse effects of the SLT consumption on periodontal tissues. METHODS: This cross sectional study was conducted in Karachi, Pakistan. It recruited 377 users of (SLT) with 231 males (61.3%) and 146 females (38.7%) of age 15 to 45 years. After obtaining informed consent, quantitative data were collected via a questionnaire followed by intra oral clinical examination to determine presence of periodontal diseases using community periodontal index (CPI). To determine the association between periodontal diseases and smokeless tobacco consumption habits, Chi Square test was conducted. RESULTS: Gingival recession (Class II-IV) (65.8%) was the most prevalent periodontal disease among SLT users. CPI score was high (CPI score 3 and 4) in 31.3% participants, whereas tooth loss was found in 21%. Among types of SLT products, gutka (28.6%) and betel quid (23.3%) were most commonly used. Using SLT for five or more years was found to be associated with a high CPI score, gingival recession (Class II-IV), moderate to severe tooth mobility, and presence of tooth loss. CONCLUSIONS: The study found statistically significant association between duration in years of using SLT and periodontal disease including gingival recession, tooth mobility and tooth loss. However, no significant results were found between retention during single use and frequency of SLT use per day. However, the link of these factors with the periodontal disease cannot be eliminated.

Clinical investigation of gingival papilla recession after orthodontic treatment in adults.

OBJECTIVE: To investigate the incidence, severity, susceptibility sites of gingival papillary recession (GPR) in adults after orthodontic treatment and the clinical impact of tooth extraction on GPR. METHODS: A total of 82 adult patients were recruited and then divided into extraction and non-extraction groups according to whether the orthodontic teeth were extracted (teeth that needed to be extracted when performing orthodontic treatment). The gingival conditions of the two groups of patients before and after treatment were recorded using intraoral photos, and the incidence, severity and predilection sites of GPR after correction were investigated. RESULTS: The results indicated that GPR occurred in 29 patients after correction, with an incidence rate of 35.4%. A total of 1648 gingival papillae were recorded among the 82 patients after correction, of which 67 exhibited atrophy, with an incidence of 4.1%. All occurrences of GPR were classified as papilla presence index 2 (PPI 2) (mild). The condition is most likely to occur in the anterior tooth area, especially in the lower incisor area. The results indicated that the incidence of GPR was substantially higher in the extraction group than in the non-extraction group, with the difference statistically significant. CONCLUSION: Following orthodontic treatment, adult patients will have a certain proportion of mild GPR, which is more common in the anterior tooth area, especially the lower anterior tooth area.

Interactions between Orthodontic Treatment and Gingival Tissue.

In recent years, as the number of adults seeking orthodontic treatment has increased, so too has the number of periodontal tissue problems, particularly regarding the impact on periodontal tissue of receiving orthodontic treatment. Orthodontic treatment improves the occlusion and appearance of teeth by moving the teeth appropriately. These movements have a significant impact on the interactions between the teeth and periodontal tissues. Orthodontic treatment can also recover tooth alignment for patients with tooth displacement caused by periodontitis; however, orthodontic treatment also often has adverse effects on periodontal soft tissue, such as gingivitis, gingival enlargement and gingival recession. The purpose of this review is to summarise the current evidence and solid knowledge of periodontal soft tissue problems in orthodontic treatment and outline some prevention strategies.

Periodontal Phenotype Modification Using Subepithelial Connective Tissue Graft and Bone Graft in the Mandibular Anterior Teeth with Mucogingival Problems Following Orthodontic Treatment.

Among the complications of orthodontic treatment, mucogingival problems with gingival recession in the mandibular anterior teeth are challenging for clinicians. Mucogingival problems can lead to esthetic deficits, thermal hypersensitivity, tooth brushing pain, and complicated plaque control. Herein, we present a case of a 16-year-old female with gingival recession in the left mandibular central incisor after orthodontic treatment. The preoperative clinical findings showed a thin soft tissue biotype with root prominence in the mandibular anterior area. The interdental area was relatively depressed. After reflection of the full-thickness flap, root coverage using a bone graft substitute and subepithelial connective tissue graft obtained from the palatal mucosa was performed. The 6-month and 5-year postoperative clinical findings showed improved soft tissue phenotype. The cross-sectional CBCT scans 5 years after surgery showed a well-maintained labial bone plate in the mandibular incisors. Within the limitations of this case report, for patients with gingival recession in the mandibular incisors after orthodontic treatment, a successful biotype modification can be achieved with a combined procedure using subepithelial connective tissue graft with bone graft substitutes.

Assessment of the periodontal health status and gingival recession during orthodontic treatment with clear aligners and fixed appliances: A systematic review and meta-analysis.

BACKGROUND: The aim was to assess periodontal health maintenance and gingival recessions development in patients undergoing an orthodontic treatment with clear aligners (CA) and fixed appliances (FA). MATERIAL AND METHODS: An electronic search in MEDLINE, Scopus, The Cochrane Library, and Web of Science was performed up to September 2022 to identify all potential articles. Two investigators independently selected the studies according to the inclusion criteria. Prospective and retrospective studies assessing the periodontal health status and gingival recession development during the orthodontic treatment with buccal FA and CA were included. Case series, cross-sectional studies, and studies with less than two months of follow-up were excluded. Two investigators independently extracted the data from included articles and assessed risk of bias across studies using the Cochrane Collaboration tool. Qualitative and quantitative analyses of the data were performed. Pairwise meta-analysis using a random-effects model were used to compare periodontal indices between FA and CA treatment in different follow-up periods. RESULTS: From the 129 potential studies, finally 12 studies were included. Only 8 could be included in the quantitative analysis. CA seems to slightly maintain better periodontal health indices. Only plaque index in a mid-term follow-up (mean difference (MD): -0.99; 95%; Confidence interval (CI) [-1.94 to -0.03]; P=.04; I2=99%), and pocket probing depth at a long-term follow-up (MD: -0.93mm; 95% CI [-1.16 to 0.7]; P<0.0001) reported statistically significant results favoring CA. CONCLUSIONS: Up to the date there is not enough evidence to conclude that CA maintains better periodontal health during an orthodontic treatment than FA.

Papilla reconstruction for an iatrogenic RT3 gingival defect using a tuberosity soft tissue graft: A case report.

BACKGROUND: Orthognathic surgery is a reliable and safe method to improve maxillo-mandibular malformations. However, it is a complex procedure that can affect deeper structures and the terminal blood supply of specific areas, thereby affecting the results. Occasionally, despite careful digital planning and diagnosis, esthetic complications may occur, such as scarring or mucogingival alterations, including localized aseptic necrosis with associated recessions. In more severe cases, larger fragments of necrosis may be involved. METHODS AND RESULTS: The aim of this case report was to present a case, including diagnosis, treatment plan, periodontal plastic surgical technique, and follow-up for a recession type 3 (RT3) defect. This RT3 gingival defect was associated with necrotic crestal bone exposure in the anterior esthetic area resulting from a complication after orthognathic surgery. CONCLUSIONS: Partial reconstruction of the interdental papilla can be possible through consideration of the defect characteristics, use of microsurgical principles, and utilization of a suitable connective tissue grafting technique. KEY POINTS: Why is this case new information? To the authors' knowledge, there is very limited clinical and scientific evidence regarding the management of esthetic complications associated with ischemic necrosis resulting from orthognathic surgeries. This case study identified the management of papillary reconstructions of these mucogingival defects. What are the keys to the successful management of this case? For an ideal case management, adequate plaque and infection control and timely notice of the defect appearance are critical. Additionally, proper surgical soft tissue management of the affected papillae and surrounding area is required. Finally, the type of connective tissue graft to be used, its management and fixation, and proper postoperative protocols are needed for case success. What are the primary limitations to success in this case? Despite the limitations of this study, the authors consider that the treatment of mucogingival complications related to orthognathic surgeries is possible, using microsurgical concepts and connective tissue grafts to reconstruct papillae.

Complications and treatment errors in periodontal and implant therapy.

The assortment of periodontal and implant-related treatments has been continuously improved over the last 50 years. Once the decision-making process has been established and the treatment procedure applied, the partial or complete resolution of the problem (eg, periodontal probing depth reduction, clinical attachment level gain, gingival recession reduction, dental hypersensitivity decrease) and a diagnosis change with no or minimal occurrence of adverse events (ie, complications, harms, technical errors, or adverse/side effects) can be expected. The clear identification of the potential types of adverse effects, complications, or even errors is important for contemporary decision-making processes, as they may be related to different local, systemic, and technical aspects. This chapter focused on four core components: (a) providing periodontal definitions for errors, complications, harms, and side effects; (b) defining the types of risk and the clinical impact of adverse effects, errors, and complications in periodontal and peri-implant therapies; (c) evaluating the influence of accidental errors versus the lack of a proper treatment planning; and (d) reporting on the importance of establishing the "net benefit ratio" between the clinical improvements promoted by the therapy and the occurrence of potential adverse events.

Effects of fixed retainers on gingival recession - a 10-year retrospective study.

OBJECTIVE: The aetiology of gingival recessions is not fully understood, and no evidence has yet emerged of a single predisposing factor that instigates this apical shift of the gingival margin. Nonetheless, both fixed retainers and orthodontic treatment have been cited as potential risk factors. The aim of this study was to assess the effects of orthodontic treatment and orthodontic fixed retainers on gingival recessions. SUBJECTS AND METHODS: In total, 105 patients at the Department of Orthodontics at the University of Gothenburg who had undergone orthodontic treatment between 1995 - 2003 were included in this study. Intraoral photographs of the anterior segment and study casts acquired at baseline (pre-treatment), post-treatment and at the 10-year follow-up were used as recorded measurements of gingival recession and orthodontic treatment. At the 10-year follow-up, the patients were divided into two groups based on: long-term (10 years) presence of a fixed retainer [orthodontic treatment and retainer (OR) group; N = 76]; and short-term (<5 years) presence of a fixed retainer [orthodontic treatment (O) group; N = 57]. These groups were compared to a control group (C) of untreated subjects (N = 29). RESULTS: In the anterior segment, gingival recessions were not present at baseline and post-treatment between the two orthodontically treated groups. At the 10-year follow-up, there was no statistically significant difference between the two orthodontically treated groups and the controls. CONCLUSIONS: Orthodontic treatment per se does not increase the risk for gingival recessions, nor does the use of fixed retainers following orthodontic treatment.

Prevalence of gingival recession and associated etiological factors among the school children.

Objective: The objective of this study is to assess the prevalence of gingival recession (GR) and associated etiological factors among school children. Methodology: The study sample consisted of 2095 children from the Nellore region divided into three groups of age ranges from primary dentition (<7 years), mixed dentition (7-12 years), and permanent dentition (>12 years) respectively, attending the department of pediatric and preventive dentistry and the school dental health programs organized by the department. The clinical examination involved measuring GR using William's periodontal probe and evaluating associated etiological factors. Data were statistically analyzed using the Chi-square test. Results: The GR among the study population was 7.9% (n = 165). Among them, males were 46% and females were 54% (P > 0.05). The GR was more in children in the 7-12 years age group (75%), followed by <7 years (21%) and >12 years (4%) age groups. The associated factors include malocclusion (69%), deleterious habits (5%), and anomalies (26%). Anomalies showed an association with GR (P < 0.05) compared to malocclusion and deleteriousness habits (P > 0.05). Conclusion: The prevalence of GR is 7.9%, and GR is more prevalent in males and the 7-12 years age group. GR is associated with transient malocclusion, deleterious habits, and anomalies.

Do oral piercings cause problems in the mouth?

Aim This systematic review and meta-analysis aimed to synthesise the current evidence for the association of oral piercings with oral complications.Data sources Research published before January 2022 was identified from the Cochrane Library, Virtual Health Library, Web of Science, Scopus, PubMed, Embase, Google Scholar and OpenGrey databases. Experts in the field were approached via email to request access to relevant ongoing studies and unpublished results.Study design Two independent reviewers determined the eligibility of studies based on the predefined inclusion criteria. Where the outcome was unclear, a third reviewer was consulted to reach consensus. Using the Joanne Briggs institute criteria for critical appraisal, 15 studies achieved good methodological quality.Meta-analysis was conducted to determine the event rate of gingival recession and damage to teeth in participants with oral piercings and to determine odds ratios of these outcomes in participants with oral piercings compared to those without.Results In total, 54 studies published between 2000-2021 met the inclusion criteria, providing a total sample of 27,963 piercings covering various anatomical sites: tongue (39 studies), lip (29 studies) and other sites, such as oral frenula or cheek (11 studies).Meta-analysis showed that there was a 34% prevalence of dental fracture (DF) in participants with oral piercings and this was 34% for tooth wear, 33% for gingival recession (GR), 27% for non-specified dental damage and 22% for tooth chipping. A significant association was found between oral piercings and the presence of GR and DF, with a seven-fold and three-fold increased risk, respectively, when an oral piercing was present. Reporting bias was not observed and evidence certainty for these outcomes was low.Conclusions The presence of oral piercings is associated with an increased risk of gingival recession and dental fracture.