Abstract
(1) Background: This retrospective study aimed to examine the change of gingival recessions (GR) before and after orthodontic treatment (OT). (2) Methods: Patients who had at least one GR on the vestibular surface of maxillary/mandibular teeth mesial to first molars were included. GR was measured on good quality plaster models before and after OT. (3) Results: Significant improvement of mean GR at patient level was found between T0 and T1 (0.45 mm, 95% CI: 0.28, 0.62) (p < 0.001). In 51.4% of patients GRs became better, in 37.8% GRs did not change. and in 10.8% GRs became worse. At tooth level the mean GR improvement was 0.54 mm (CI: 0.42, 0.65; median 0.55 mm Q1; Q3: 0.12, 0.96) (p < 0.001). GR improved in 67 teeth (58.7%), did not change in 41 (36.0%), and worsened in 6 (5.3%). Full healing was observed in 15 teeth. A reduced GR improvement was found in cases with pre-treatment open bite (OR 3.89; CI: 1.35, 11.16; p = 0.008) and dental Class III patients (OR 2.6; CI: 1.11, 6.0; p = 0.026). (4) Conclusions: There was an improvement of GR after OT in more than half of the patients. Class III malocclusion and reduced pre-treatment overbite had a negative impact on GR improvement.
Highlights
Gingival recession (GR) is defined as the apical shift of the gingival margin with respect to the cement-enamel junction
Class III malocclusion and reduced pre-treatment overbite had a negative impact on GR improvement
Several GR classifications are available in the literature, with Miller’s four categories of GR being the most widely used in orthodontics: Class I, where marginal tissue recession does not extend to the mucogingival junction (MGJ); Class II, where marginal tissue recession extends to or beyond the MGJ, but with no interdental periodontal attachment loss; Class III, where marginal tissue recession extends to or beyond the MGJ, with interdental bone or soft tissue loss or malpositioning of teeth, and, Class IV, where marginal tissue recession extends to or beyond MGJ, with severe interdental bone or soft tissue loss and/or severe malpositioning of teeth [5]
Summary
Gingival recession (GR) is defined as the apical shift of the gingival margin with respect to the cement-enamel junction. It is associated with attachment loss and exposure of the root surface to the oral environment [1,2]. Literature about the prevalence of different extent of GR is scarce, but GR of Miller class III and IV with interdental attachment loss is usually associated with the inflammatory periodontal disease and is often not included in orthodontic research of periodontally healthy subjects [7]
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