Influence of ternion of soft tissue attributes on gingival recession and root coverage outcome – A retrospective analysis

Abstract

The independent influence of Keratinized Tissue Width (KTW) and Gingival Biotype (GB) on root coverage outcomes have been reported over the years. These parameters along with Recession Depth (RD) might act as a triad and assessing this ternion would be beneficial in determining prognosis and devising treatment plan for gingival recession. The aim of this retrospective analysis is to evaluate a possible association between KTW, GB and RD and their influence on Gingival Recession and root coverage outcome.45 isolated gingival recession defects were assessed for KTW (<2mm, >2mm), GB (thin vs thick) and RD (1-4mm). Primary outcome was to establish an association between the above-mentioned parameters. Secondary outcome was to find the percentage Root Coverage (%RC) obtained after coronally advanced flap procedure. To evaluate the relationship of KTW vs GB, GB vs RD and KTW vs RD, chi-square test was used. To analyse the intra-parametric correlation and the association between all three parameters, Pearson correlation test and ANOVA were carried out respectively.The Chi-square test results revealed a statistically significant association of p<0.03 for the relationship of KTW vs GB and GB vs RD and p<0.001 for KTW vs RD. Pearson correlation test showed a positive correlation between KTW and GB (.320), negative correlation between GB and RD (-.046), and KTW and RD (-.136). ANOVA showed a p-value of 0.041 inferring that any change in KTW and GB significantly influenced RD. Sites with <2mm KTW, thin GB and deeper RD, which can be referred to as negative ternion, exhibited 43.8% mean RC while sites with >2mm KTW, thick GB and shallow RD, which can be referred to as positive ternion had 94.7% mean RC. There is a definitive association between Keratinized Tissue Width, Gingival Biotype and Recession Depth. A ternion of these parameters greatly influences the outcome of root coverage procedures.