Abstract
The objectives of this study were to assess gingival recessions (GR) and periodontal status in patients previously treated with non-extraction orthodontic treatment and retention at a follow-up of a minimum of two years after the end of treatment. Data from patients aged between 16 and 35 years with a previous non-extraction orthodontic treatment and at least 2 years of retention and full records before and after treatment were collected. The casts were digitalized using the 3Shape TRIOS® intraoral scanner and the Viewbox4 software was used for the measurements. The following parameters were scored: inclination of the lower and upper incisors (IMPA and I^SN) and anterior crowding (Little index). The included patients were recalled for a clinical periodontal follow-up examination and the following parameters were evaluated: buccal and lingual GR (mm) of incisors and canines, bleeding of probing score, plaque score, and gingival phenotype. The digital cast analysis showed a mean Little index of 7.78 (SD 5.83) and 1.39 (SD 0.79), respectively, before and after treatment. The initial and final cephalometric analyses showed an I^SN of 103.53° and 105.78° (SD 7.21) and IMPA of 91.3°and 95.1°, respectively. At the follow-up periodontal visits, the patients showed an overall low oral hygiene with bleeding at probing in 66.6% and plaque in the anterior area in 76.2% of patients. From the total examined 240 teeth of the frontal sextants, three patients had GR (from 1 to 6.5 mm): in the upper arch two at canines and one at central incisor, whereas in the lower arch two at central and one at lateral incisors. The gingival phenotype was thick in 55% of cases. The lingual-to-lingual retainers at follow-up were present in 61.9% of patients. A slight increased risk for buccal GR development was found only in correlation with the presence of fixed retainer and thin gingival phenotype mainly in patients with gingivitis. Thus, non-extraction orthodontic treatment performed with controlled forces and biomechanics seems to not affect the development of GR or the periodontal health after retention.
Highlights
Gingival recession (GR) is defined as the apical shift of the gingival margin with respect to the cementoenamel junction (CEJ) [1]; it is associated with attachment loss and exposure of the root surface to the oral environment [2,3,4]
A thin gingival phenotype was described as a risk factor for inflammation-related GR in the presence of tooth-brushing trauma [14,15] and poor oral hygiene with plaque accumulation [16]
Data recruitment started in March 2020 and the sample included patients who had consecutively completed their orthodontic treatment between October 2012 and February 2018 at the Orthodontic Program of the University of Campania Luigi Vanvitelli, Naples (Italy)
Summary
Gingival recession (GR) is defined as the apical shift of the gingival margin with respect to the cementoenamel junction (CEJ) [1]; it is associated with attachment loss and exposure of the root surface to the oral environment [2,3,4]. Several predisposing risk factors have been suggested, such as periodontal phenotype, tooth type and position in the dental arch, amount of attached gingiva, and lack of alveolar buccal bone as well as age, gender, and ethnicity [7,8,9,10,11,12,13]. A thin gingival phenotype was described as a risk factor for inflammation-related GR in the presence of tooth-brushing trauma [14,15] and poor oral hygiene with plaque accumulation [16]
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