Abstract
Background It is crucial to maintain periodontal health in patients undergoing orthodontic treatment. Biotype is a critical factor to be considered in this regard. This systematic review investigated the scientific evidence on the relationship between gingival biotype and marginal periodontal alterations induced by orthodontic interventions. Methods An electronic search was conducted for pertinent studies in three databases: PubMed, Scopus, and Cochrane up to August 1, 2019 based on a detailed protocol according to the PRISMA statement. The authors also completed a hand search in six dental journals and the bibliographic lists of the relevant studies.Results Of 1512 citations retrieved through the electronic search, 602 were duplicate entries. By evaluating titles, abstracts, and full texts, eight articles conformed to the inclusion criteria; however, no relevant studies were found through hand searching. The evidence suggested that recession was inversely related with the thickness of the facial margin. These findings were more evident in proclined teeth and patients using fixed appliances. Conclusion The existing evidence suggests that orthodontic therapy might result in mild detrimental effects on the periodontium, especially in patients with thin biotype. However, due to the limited investigations and their inconsistent methodology, further well-designed prospective studies are necessary.
Highlights
This study investigated the scientific evidence on the relationship between gingival biotype and periodontal changes caused by orthodontic movements
-Intervention: We focused on studies assessing fixed or removable orthodontic appliances, or both
Orthodontic appliances might damage periodontal tissues by creating retentive areas for dental plaque; even with excellent oral hygiene, the appliances cause a change in the intraoral microflora, leading to a bacterial array similar to that present in sites affected by periodontal disease.[31]
Summary
Lindhe and Seibert[10] used the term “periodontal biotype” to describe morphologic characteristics of the periodontium. There are two types of gingival biotype: “thin scalloped” and “thick flat.”[11,12] The biotype depends on many factors, including age, sex, genetic factors, as well as the shape, position, and size of the teeth.[13] In addition, the width and thickness of the facial gingiva vary from one individual to another, and even in different regions of a mouth. There are diverse “gingival phenotypes,” a term used by Muller and Eger[14] for the first time. Studies have shown that gingival thickness plays a fundamental role in mucogingival problems. As the attachment level is minimal in thin biotype, it is more prone to trauma and inflammation.[15,16,17] accurate pre-orthodontic evaluation of the biotype has been recommended in order to preclude potential complications.[17,18,19]
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