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Purpose: Several classification systems have been proposed in the literature, but none of them has been validated by means of an appropriate statistical analysis and, therefore, it is unknown whether these systems work in the same manner among different clinicians. The aim of the present study is to investigate the intra- and inter-rater agreement of a new system to classify gingival recession defects and to evaluate its agreement among different clinicians. Materials and methods: A new classification system was proposed and tested considering the following three factors: the amount of keratinised tissue (<2 or ≥2 mm), the presence/absence of noncarious cervical lesions and the presence/absence of interproximal attachment loss. Kappa-statistics were performed to analyse the intra-rater and inter-rater agreement among three blinded examiners. Results: A total of 120 gingival recessions were evaluated using the new classification system. The intra-rater agreement ranged from 0.74 to 0.96 for the variable keratinised tissue, from 0.67 to 0.94 for the variable non-carious cervical lesions and from 0.70 to 0.92 for the variable interproximal attachment loss. The inter-rater agreement values ranged from 0.70 to 0.85 for keratinised tissue, from 0.54 to 0.59 for non-carious cervical lesions and from 0.54 to 0.77 for the interproximal attachment loss. Conclusions: Based on the results of this study, the proposed new classification system showed moderate to substantial agreement among investigators when used in the present study population and was therefore able to diagnose the severity of gingival recession defects. [ABSTRACT FROM AUTHOR]

The present case series study illustrates two different mucogingival techniques for treating gingival recessions associated with deep dental abrasions. The therapeutic strategies depend on the depth of the abrasion measured at the mid most coronal point at the CEJ level (CEJ step). When the CEJ step was <1 mm, a connective tissue graft associated with an extremely positioned coronal flap was performed. In case of a CEJ step ≥1 mm, a double connective tissue graft with an extremely positioned coronal flap was used. The dental abrasions and/or CEJ were not mechanically treated in either situation. One year later, the results showed a recession reduction of 97.5%, with complete root coverage obtained in 82% of sites, and dental hypersensitivity reduction obtained in 5 out of the initial 7 sites. There were no new cases of dental hypersensitivity at the end of follow-up period as a consequence of the treatment. This case series report shows that optimal clinical results in terms of complete root coverage of gingival recessions associated with deep cervical abrasions can be achieved by performing an appropriate surgical procedure without removing dental tissue. [ABSTRACT FROM AUTHOR]