Risk indicators for gingival recession in the esthetic zone: A cross‐sectional clinical, tomographic, and ultrasonographic study

Background To evaluate the risk indicators associated with midfacial gingival recessions (GR) in the natural dentition esthetic regions. Methods Cone‐beam computed tomography (CBCT) results of thirty‐seven subjects presenting with 268 eligible teeth were included in the cross‐sectional study. Clinical measurements included presence/absence of midfacial GR; the depth of the midfacial, mesial, and distal gingival recession; the recession type (RT); keratinized tissue width (KT); and attached gingiva width (AG). Questionnaires were utilized to capture patient‐reported esthetics and dental hypersensitivity for each study tooth. Buccal bone dehiscence (cBBD) and buccal bone thickness (cBBT) were measured on the CBCT scans. High‐frequency ultrasonography was performed to assess gingival thickness (GT) and buccal bone dehiscence (uBBD). Intraoral optical scanning was obtained to quantify the buccolingual position of each study site (3D profile analysis). Multilevel logistic regression analyses with generalized estimation equations were performed to assess the factors associated with the conditions of interest. Results The presence of midfacial GR was significantly associated with the history of periodontal treatment for pocket reduction (OR 7.99, p = 0.006), KT (OR 0.62, p