Mahajan's Modification of the Miller’s Classification for Gingival Recession

Dental Hypotheses 08/2010; 1(2). DOI: 10.5436/j.dehy.2010.1.0009
Source: DOAJ


Introduction: Miller has primar-ily based his classification of gingival recession defects on two aspects: Extent of gingival recession defects and Extent of hard and soft tissue loss in interdental areas surrounding the gingival recession defects. Based on the above criteria Miller classified the gingival re-cession defects into four classes and also took prognosis into account. The prognosis decreases from class 1 to class 4 and the treatment options are also limited from class 1 having maximum treatment options and class 4 having minimum options for treatment. The hypothesis: At first glance classification looks comprehensive and simple to use but close screening points out some of the inherent drawbacks associated in this classification system. Since the ultimate goal of any classification system is to facilitate common standardized identification of the condition under consideration, aid in di-agnosis and prognosis and thus finalizing an appropriate treat-ment plan for the condition; the present manuscript is an attempt to emphasize the need to modify Miller’s classification to make it more comprehensive and updated according to the recent concepts.Evaluation of the hypothesis: The hypothesis highlights some inherent drawbacks and necessary changes in Miller’s Classification system and emphasizes the need to update it.

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Available from: Ajay Mahajan, Jul 27, 2014

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Article: Mahajan's Modification of the Miller’s Classification for Gingival Recession

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    • "In addition, such systems give clinicians a way to organize the health-care needs of their patients. The importance of developing new improved classification system lies in the fact that recent studies have pointed out some inherent limitations and drawbacks in the already popular classification systems.[13141516] Although most of the clinicians are aware about the clinical implications of GRD, but until date there is no consensus on the various classifications used to classify GRD therefore, considering all these aspects, the present study was carried out to test the reliability of a new classification system for classifying GRD evolved from the popular Miller's classification system. "
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    ABSTRACT: Gingival recession defects (GRD) are one of the most commonly encountered conditions for which periodontal treatment is required. Several attempts have been made to classify GRD. Among all the classifications Millers classification for gingival recessions is the most accepted. Recently, several limitations and drawbacks have been pointed out in Miller's classification system. The aim of the present study is to test the reliability of the recently proposed Mahajan's Modification of the Miller's Classification for GRD. All 15 males and 11 females between the ages of 22 and 55 years (mean age, 37.15 year) with at least one buccal gingival recession were consecutively recruited by the same periodontist in order to test the reliability of the new classification of GRD. The classification was tested by two examiners blinded to the data collected by the other examiner. Intra-rater and inter-rater agreement was assessed. The new classification system of gingival recessions was tested in a total of 175 gingival recessions in 26 patients. The intraclass correlation coefficient for inter-rater agreement was 0.90, showing an almost perfect agreement between the examiners. The newly proposed classification system eliminates the drawbacks and limitations associated with Miller's classification system and can be used to classify GRD reliably.
    Full-text · Article · Mar 2014 · Journal of Indian Society of Periodontology
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    ABSTRACT: Pini-Prato G. The Miller classification of gingival recession: limits and drawbacks. J Clin Periodontol 2011; 38: 243-245. 38: 243-245. doi: 10.1111/j.1600-051X.2010.01655.x.
    No preview · Article · Mar 2011 · Journal Of Clinical Periodontology
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    ABSTRACT: 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. 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 non carious 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. 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. 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.
    No preview · Article · Jun 2011 · European Journal of Oral Implantology
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