title: Risk Indicators of Papillary Recession in the Anterior Maxilla.
abstract: OBJECTIVE
  The interdental papilla is the portion of the gingiva that occupies the space between two adjacent teeth. When papillary recession occurs, an array of problems arises ranging from phonetics to food impaction and esthetic concerns. The aim of this study was to identify risk indicators for visible papillary recession in the anterior maxilla among a Caucasian population utilizing an advanced analytical approach.
  
  
  METHODS
  A dataset of 211 adult dentate Caucasian patients that had undergone intraoral assessment of midline papillary recession and extra-oral assessment of visible papillary recession during maximum ("Duchenne") smile was utilized. An enhanced analytical approach was employed to identify risk indicators for papillary recession.
  
  
  RESULTS
  Approximately one-third of the participants (38%) demonstrated papillary recession during maximum smile ("visible papillary recession"). An association between sex (male preference) and visible papillary recession was found in this sample population, while age was found to be a risk indicator for papillary recession in individuals over 65 years of age.
  
  
  CONCLUSIONS
  Visible midline papillary recession in the maxilla is a highly prevalent clinical entity in Caucasian individuals, thus the development of efficacious treatment modalities for papillary regeneration is necessary. Findings of the present study on risk indicators for visible papillary absence, namely sex and age, may facilitate clinicians in treating patient with compromised interdental aesthetics as well as identifying patients that are in high risk for loss of interdental tissues.
  
  
  CONCLUSIONS
  Findings of the present study on risk indicators for visible papillary absence, namely sex and age, indicate the need for careful assessment and meticulous treatment planning with respect to preservation of the interdental tissues. The consideration of these risk indicators can help dentists to identify patients at risk for papillary recession.
authors.affiliation: Advanced Education Program in Periodontology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Andreas L
authors.initials: AL
authors.lastname: Ioannou
authors.affiliation: Advanced Education Program in Periodontology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Vasiliki P
authors.initials: VP
authors.lastname: Koidou
authors.affiliation: International Postgraduate Program in Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Georgia I
authors.initials: GI
authors.lastname: Kamintzi
authors.affiliation: Advanced Education Program in Periodontology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Hinrichs
authors.affiliation: Advanced Education Program in Periodontology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Georgios A
authors.initials: GA
authors.lastname: Kotsakis
authors.affiliation: Department of Periodontology, School of Dental Medicine, Stony Brook, NY, USA.
authors.forename: Georgios E
authors.initials: GE
authors.lastname: Romanos
mesh_terms: D000328:Adult; D005260:Female; D005889:Gingival Recession / Q000601:surgery*; D006801:Humans; D008297:Male; D008437:Maxilla / Q000473:pathology*; D008875:Middle Aged; D012307:Risk Factors