Abstract Background To assess clinical and anatomical risk indicators for mid‐buccal gingival recessions (GRs) in the mandibular anterior region using digital and tomographic tools. Methods A cross‐sectional study was conducted on 103 patients (618 teeth). Clinical examination, intraoral scanning, and cone‐beam computed tomography (CBCT) were combined to record the keratinized tissue width (KTW), gingival phenotype, GR type (RT), probing pocket depth, clinical attachment level, recession depth (RD), tooth‐ridge angulation, tooth malpositioning (TM), buccal bone thickness (BBT), buccal bone dehiscence (BBD), root prominence (RP), gingival thickness (GT), and papilla height (PH). Associations with GR were analyzed using multilevel regression with generalized estimation equations. Results Gingival recession was observed in 70.9% of patients and 38.3% of teeth, most often RT2. Central incisors were most affected. Univariate analysis associated GR to age, tooth type, TM, reduced KTW, decreased BBT, increased BBD, and RT, while thicker phenotypes showed protective effects. Multivariable analysis confirmed five independent predictors: age, tooth type, TM (OR = 3.11), reduced KTW (OR = 0.64), and greater BBD (OR = 1.64). RD increased with age (+0.03 mm/year) and BBD (+0.21 mm). Conclusions Tooth malposition, inadequate KTW, and BBD are key risk indicators for gingival recession in the mandibular anterior region. Their identification is essential for preventive and therapeutic strategies. Plain language summary Gingival recession, the apical migration of the gingival margin, is a common condition with implications for dental sensitivity, esthetics, and long‐term periodontal health. The lower anterior region is particularly susceptible, yet the anatomical and clinical factors contributing to this vulnerability are not fully defined using digital tools. In this cross‐sectional study of 103 patients (618 teeth), we integrated clinical examination, digital intraoral scanning, and CBCT to quantify soft and hard tissue characteristics. Recession was present in 70.9% of patients and 38.3% of teeth, predominantly affecting the central incisors. Multivariable analysis identified five independent risk indicators: older age, tooth type, tooth malposition, reduced keratinized tissue width, and buccal bone dehiscence. Recession depth increased with age and dehiscence severity. These findings underscore the critical role of both soft and hard tissue anatomy in determining susceptibility to gingival recession, providing a framework for risk assessment, preventive strategies, and individualized treatment planning in clinical practice.
Blasi et al. (Mon,) studied this question.
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