Development of a system to assess visible and hidden gingival recession

The accurate assessment of gingival recession is important because of soft tissue deterioration and/or the state of soft tissue health. While recession of the gingival margin is a common and important symptom of periodontal disease, it also refers to the location of the gingiva and not to its condition. Recession can occur at all tooth surfaces. This paper describes a new system designed to measure two parameters of gingival recession. One parameter of recession is visible above the gumline to an observer, while another parameter is hidden by the gingiva itself. Visible recession is the shift of the marginal gingiva to a position apical to the cemento-enamel junction. Hidden recession is obscured by gingiva and can be assessed by measuring from the free gingival margin to the level of epithelial attachment. The system developed here differs from the current indices commonly used for gingival recession, since it combines both the visual portion with the hidden portion of recession for a total score. The assessment method is similar to the calculus scoring procedure of Volpe and Manhold and is called the Gingival Recession Total (GRT) scoring system.