Keywords
etiology
gingival recession
interdental papilla
mucogingival junction
prevalence
Abstract
Gingival recession is a widely prevalent mucogingival deformity with esthetic and functional consequences. Since Sullivan and Atkins first proposed a classification in 1968, numerous systems have attempted to standardize diagnosis and prognosis, including Miller’s widely adopted marginal tissue recession (1985) classification. As Miller’s system expanded the horizon of recession classification beyond shape and size, it also provided prognostic guidance for root coverage. However, limitations such as difficulty in identifying the mucogingival junction and ambiguity between classes had prompted further refinements. Cairo’s 2011 Recession Type system improved prognostic accuracy by incorporating interproximal attachment loss, and the 2017 World Workshop extended the treatment-oriented classification by integrating recession type, gingival phenotype, and root surface features into a 4×5 matrix. In 2018, Miller revisited his classification system again after 3decades, incorporating papilla dimensions and emphasizing the role of attached gingiva, cautioning against oversimplification in then newer popular systems. Together, the evolution of these classification systems also portrays the evolution of periodontology from mucogingival surgery to perioplastic surgery era. This article outlines the basis, drawbacks and limitations of various classification systems proposed to classify gingival recession over time.
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