Gingival recession: its causes and types, and the importance of orthodontic treatment

Abstract

Gingival recession has direct causes and predisposing factors. Orthodontic treatment is able to prevent recession and even contribute to its treatment, with or without periodontal approach, depending on the type and severity of gingival tissue damage. There is no evidence on the fact that orthodontic treatment alone might induce gingival recession, although it might lead the affected teeth (usually mandibular incisors or maxillary canines) to be involved in situations that act as predisposing factors, allowing direct causes to act and, therefore, trigger recession, especially when the buccal bone plate is very thin or presents with dehiscence. Several aspects regarding the relationship between orthodontic treatment and gingival recession have been addressed, and so has the importance of the periosteum to the mechanism of gingival recession formation. Clinical as well as experimental trials on the subject would help to clarify this matter, of which understanding is not very deep in the related literature.

Prevalence of non-carious cervical lesions among the general population of the Republic of Srpska, Bosnia and Herzegovina

“…Elderly people are exposed to various aetiological factors, which result in deterioration of functionality and aesthetics of the dentition over time 9 . The aging process in humans manifests from the cumulative effect of many aetiological factors, providing the opportunity for a recession in the dentition stemming from gingival retraction, bone loss, root surface and cementum exposure, leading ultimately to cervical lesions 28 . The majority of lesions could also have been overlooked at earlier ages; contributing to the later common occurrence of NCCLs 29,30 .…”

Incisor proclination and gingival recessions: is there a relationship?

“…Although its etiology has not been completely elucidated, gingival recession may be associated with orthodontic treatment 20,22 . Therefore, knowing that gingival recession may be a side effect of orthodontic therapy, identifying the factors that may contribute to the development of recessions is of great importance 5 . In this study, we investigated the relationship between the amount of change in inclination of the mandibular incisors during orthodontic treatment, and the changes that occurred in the LCC of these teeth, immediately after removal of the appliance, and three years later.…”

“…Although its etiology is unclear, periodontal disease and mechanical trauma are considered the primary factors in the pathogenesis of gingival recessions 4 . Orthodontic treatment might promote the development of recessions 5 , with a possible mechanism being that orthodontic tooth movement can result in root positions close to or outside alveolar cortical plates; this can lead to bone dehiscences 6,7 . As a result, a marginal gingiva without proper alveolar bone support can migrate apically, leading to root exposure 8 .…”

“…Consequently, the dynamics of the development of gingival recessions could not have been evaluated. Moreover, the studies did not establish safe limits with regard to the amount of vestibular inclination of mandibular incisors allowed, so that clinicians may make their decisions at the time of leveling the curve of Spee 5,12 . The aim of this retrospective study was to test the following null hypothesis: there is no relationship between the amount of buccal inclination of mandibular incisors and the appearance of gingival recession in this region.…”

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“…13 A variety of precipitating factors have shown to be associated with recession of gingival margin: oral hygiene habits like traumatic tooth-brushing & tooth malpositioning, 14 high frenum or muscle attachment, 15 alveolar bone dehiscence, 16 plaque & calculus 17 and iatrogenic factors related to restorative and periodontal treatment procedures. 18 Clinically gingival recession results in exposed root surfaces and loss of marginal tissue attachment. Along with the esthetic concerns, root surface exposure may produce dental hypersensitivity and lead to discomfort for the patient.…”