Systematic review and meta-analysis on prevalence and risk factors for gingival recession
Felix Marschner, Clemens Lechte, Philipp Kanzow, Valentina Hraský, W. Pfister
Abstract
• Gingival recession is a prevalent condition in the general population worldwide. • Male gender, smoking, and alcohol consumption are significant risk factors. • Dental plaque increases the risk of the formation of gingival recessions. • Factors like a high frenulum and occlusal trauma contribute to gingival recessions. • Periodontitis and previous periodontal treatment are linked to gingival recessions. Gingival recession is a common mucogingival condition. The aim of this systematic review and meta-analysis was to assess the prevalence of gingival recession and identify associated risk factors in the general population. Observational studies reporting prevalence and risk factors for gingival recession published since 2000 were included. Methodological quality was assessed using the modified Newcastle-Ottawa scale for cross-sectional studies. Random-effect meta-analyses were conducted for the prevalence (%) of gingival recession at different cut-off scores (≥1 mm, ≥3 mm, and ≥5 mm) and odds ratios (OR) of identified risk factors. MEDLINE, Embase, Scopus, and Web of Science were systematically searched in November 2024. Additionally, a hand search was performed. The study was registered in PROSPERO (CRD42024516816). 21 sources, reporting on 22 studies were included in this systematic review. Most of the included studies represented a low risk of bias. Overall, estimated prevalence of gingival recession was 81.1 % (95 %-CI: 73.9–86.7) for ≥1 mm, 48.4 % (95 %-CI: 39.7–57.2) for ≥3 mm, and 16.2 % (95 %-CI: 9.1–27.4) for ≥5 mm. Risk factors were structured into domains. Meta-analyses revealed male gender (p adj. <0.001; OR=1.52, 95 %-CI: 1.36–1.69), smoking (p adj. =0.003; OR=1.84, 95 %-CI: 1.33–2.53), alcohol consumption (p adj. <0.001; OR=2.04, 95 %-CI: 1.51–2.75), dental plaque (p adj. <0.001; OR=4.26, 95 %-CI: 2.91–6.24), presence of a high frenulum (p adj. <0.001; OR=4.58, 95 %-CI: 2.58–8.11), occlusal trauma (p adj. =0.003; OR=3.20, 95 %-CI: 1.74–5.87), periodontitis (p adj. <0.001; OR=9.90, 95 %-CI: 4.15–23.60), and history of periodontal treatment (p adj. <0.001; OR=1.86, 95 %-CI: 1.33–2.58) to be significantly associated with gingival recession. Observational studies indicated that gingival recession is a highly prevalent condition associated with a variety of risk factors. Gingival recession is associated with periodontal conditions like periodontitis, high frenulum, and modifiable factors such as smoking, alcohol consumption, and occlusal trauma. Clinicians should primarily focus on identifying these risk factors and implementing preventive strategies.