Journal of Indian Society of Periodontology
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   Table of Contents    
LETTER TO EDITOR
Year : 2014  |  Volume : 18  |  Issue : 4  |  Page : 427  

Author's reply


Department of Periodontics, Himachal Pradesh Government Dental College and Hospital, Shimla, Himachal Pradesh, India

Date of Web Publication14-Aug-2014

Correspondence Address:
Ajay Mahajan
Department of Periodontics, Himachal Pradesh Government Dental College and Hospital, Snowdon, Shimla 171 001
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Mahajan A, Kashyap D, Kumar A, Mahajan P. Author's reply. J Indian Soc Periodontol 2014;18:427

How to cite this URL:
Mahajan A, Kashyap D, Kumar A, Mahajan P. Author's reply. J Indian Soc Periodontol [serial online] 2014 [cited 2020 Jun 4];18:427. Available from: http://www.jisponline.com/text.asp?2014/18/4/427/138675

Sir,

It was good to read the comments regarding our article on "Reliability of Mahajan's classification of gingival recessions: A pioneer clinical study." In this context, the authors of the letter to the editor have pointed out some specific questions, which we want to clarify:

  • Regarding confusion in Class 1 and 2: The authors of the letter to the editor have stated "in this aspect, Miller's classification specifies the level of facial loss (marginal tissue loss to or beyond mucogingival junction), whereas Mahajan's classification has no provision to specify the loss of facial tissue." which is not a valid statement as the classification system given by Mahajan also takes marginal tissue position into consideration for classifying Class 1 and 2 recession defects, also the definition of gingival recession itself explains the involvement of marginal gingiva in any classification system. [1] We recommend that the authors of the letter to the editor should go through the Mahajan's classification system once again [2]
  • Confusion regarding Class 3 and 4: Distinction between gingival recession Class (1 and 2) and Class (3 and 4) is based upon the involvement of interproximal bone loss in Class (3 and 4) in contrast to Class (1 and 2) (again derived from Miller's original classification), which is quiet simple to understand. Furthermore, the doubt that Mahajan's classification doesn't include facial tissues is quiet interesting as it's obvious that gingival recessions are being discussed in terms of root denudation and not solely on basis of the loss of interproximal tissue. [3],[4] We recommend the author of the letter to the editor to see the clinical pictures published in the article to depict the various classification classes [2]
  • Regarding noninclusion of palatal recessions: The authors of Mahajan's classification have themselves already mentioned in the published article that one theoretical limitation of their classification is noninclusion of palatal recessions (page 41, last para line 11) and the reason suggested by Mahajan et al., [2] is quiet valid as most of the current evidence suggests that all the treatment options available till date are directed toward treatment of buccal gingival recessions not the palatal ones. [5],[6]


We also want to underscore the facts that:

Despite all the limits and drawbacks, Miller's classification system is the most popular, clinician friendly and practical system to classify gingival recessions till date and the given classification system by Mahajan et al., [2] is derived from the original Miller's classification system to classify gingival recessions with some modifications to eliminate the major drawbacks associated with the original Miller's classification.

Our classification system should not be viewed as a " de novo" system as it still has Miller's classification as its basis and purposely too as we feel that being used for more than three decades the majority of the clinicians who are accustomed to Miller's classification system will accept the modifications with ease instead of adapting a totally new classification system, which may be more theoretically apt but practically/clinically unfit.

We hope we have answered most of the doubts raised in the letter to the editor and welcome further suggestions.

 
   References Top

1.Caranza FA, Takey HH. Muco-gingival surgery. In: Caranza FA, Newman MG, editors. Clinical Periodontology. 8 th ed., Ch. 59. Philadelphia: WB Saunders Company; 1996. p. 651-71.  Back to cited text no. 1
    
2.Mahajan A, Kashyap D, Kumar A, Mahajan P. Reliability study of Mahajan's classification of gingival recession: A pioneer clinical study. J Indian Soc Periodontol 2014;18:38-42.  Back to cited text no. 2
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3.Pini-Prato G, Franceschi D, Cairo F, Nieri M, Rotundo R. Classification of dental surface defects in areas of gingival recession. J Periodontol 2010;81:885-90.  Back to cited text no. 3
    
4.Chambrone L, Lima LA, Pustiglioni FE, Chambrone LA. Systematic review of periodontal plastic surgery in the treatment of multiple recession-type defects. J Can Dent Assoc 2009;75:203a-203f.  Back to cited text no. 4
    
5.Chambrone L, Sukekava F, Araújo MG, Pustiglioni FE, Chambrone LA, Lima LA. Root-coverage procedures for the treatment of localized recession-type defects: A Cochrane systematic review. J Periodontol 2010;81:452-78.  Back to cited text no. 5
    
6.Pini-Prato G, Nieri M, Pagliaro U, Giorgi TS, La Marca M, Franceschi D, et al. Surgical treatment of single gingival recessions: Clinical guidelines. Eur J Oral Implantol 2014;7:9-43.  Back to cited text no. 6
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