Combined Orthodontic-Orthognathic Approach for Dentofacial Deformities as a Risk Factor for Gingival Recession: A Systematic Review

Paulo, João Paulo Mota de; Mendes, Felipe Herbert de Oliveira; Filho, R.T. Gonçalves; Marçal, Felipe Franco

doi:10.1016/j.joms.2020.05.040

Cited by 4 publications

(2 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This allows the clinician to quickly detect complications, determine causation, and execute a treatment plan. Regarding complications, gingival recessions have been reported between 0.5 and 3.0 mm and are more commonly associated with mandibular anterior teeth 9 . Furthermore, there is a correlation between bone and tissue thickness, amount of surgical displacement, and resulting tissue compromise due to larger decreases in blood flow to the area 10,11 .…”

Section: Discussionmentioning

confidence: 99%

“…Regarding complications, gingival recessions have been reported between 0.5 and 3.0 mm and are more commonly associated with mandibular anterior teeth. 9 Furthermore, there is a correlation between bone and tissue thickness, amount of surgical displacement, and resulting tissue compromise due to larger decreases in blood flow to the area. 10,11 If diminished blood flow persists, complications can be seen up to 90 days post-surgery.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Papilla reconstruction for an iatrogenic RT3 gingival defect using a tuberosity soft tissue graft: A case report

Chacón

Saleh

Fleming

et al. 2023

Clin Adv Periodontics

View full text Add to dashboard Cite

BackgroundOrthognathic surgery is a reliable and safe method to improve maxillo‐mandibular malformations. However, it is a complex procedure that can affect deeper structures and the terminal blood supply of specific areas, thereby affecting the results. Occasionally, despite careful digital planning and diagnosis, esthetic complications may occur, such as scarring or mucogingival alterations, including localized aseptic necrosis with associated recessions. In more severe cases, larger fragments of necrosis may be involved.Methods and ResultsThe aim of this case report was to present a case, including diagnosis, treatment plan, periodontal plastic surgical technique, and follow‐up for a recession type 3 (RT3) defect. This RT3 gingival defect was associated with necrotic crestal bone exposure in the anterior esthetic area resulting from a complication after orthognathic surgery.ConclusionsPartial reconstruction of the interdental papilla can be possible through consideration of the defect characteristics, use of microsurgical principles, and utilization of a suitable connective tissue grafting technique.Key pointsWhy is this case new information? To the authors’ knowledge, there is very limited clinical and scientific evidence regarding the management of esthetic complications associated with ischemic necrosis resulting from orthognathic surgeries. This case study identified the management of papillary reconstructions of these mucogingival defects. What are the keys to the successful management of this case? For an ideal case management, adequate plaque and infection control and timely notice of the defect appearance are critical. Additionally, proper surgical soft tissue management of the affected papillae and surrounding area is required. Finally, the type of connective tissue graft to be used, its management and fixation, and proper postoperative protocols are needed for case success. What are the primary limitations to success in this case? Despite the limitations of this study, the authors consider that the treatment of mucogingival complications related to orthognathic surgeries is possible, using microsurgical concepts and connective tissue grafts to reconstruct papillae.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Papilla reconstruction for an iatrogenic RT3 gingival defect using a tuberosity soft tissue graft: A case report

Chacón

Saleh

Fleming

et al. 2023

Clin Adv Periodontics

View full text Add to dashboard Cite

show abstract

Exploring the relationship between the number of systematic reviews and quality of evidence: an orthognathic surgery-based study

Grillo

Borba

Silva

et al. 2024

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

View full text Add to dashboard Cite

Multi-disciplinary treatment of maxillofacial skeletal deformities by orthognathic surgery combined with periodontal phenotype modification: A case report

Liu¹,

Li²,

Ya³

et al. 2022

WJCC

View full text Add to dashboard Cite

BACKGROUND Maxillofacial deformities are skeletal discrepancies that cause occlusal, functional, and esthetic problems, and are managed by multi-disciplinary treatment, including careful orthodontic, surgical, and periodontal evaluations. However, thin periodontal phenotype is often overlooked although it affects the therapeutic outcome. Gingival augmentation and periodontal accelerated osteogenic orthodontics (PAOO) can effectively modify the periodontal phenotype and improve treatment outcome. We describe the multi-disciplinary approaches used to manage a case of skeletal Class III malocclusion and facial asymmetry, with thin periodontal phenotype limiting the correction of deformity. CASE SUMMARY A patient with facial asymmetry and weakness in chewing had been treated with orthodontic camouflage, but the treatment outcome was not satisfactory. After examination, gingiva augmentation and PAOO were performed to increase the volume of both the gingiva and the alveolar bone to allow further tooth movement. After orthodontic decompensation, double-jaw surgery was performed to reposition the maxilla-mandibular complex. Finally, implant placement and chin molding were performed to restore the dentition and to improve the skeletal profile. The appearance and function were significantly improved, and the periodontal tissue remained healthy and stable. CONCLUSION In patients with dentofacial deformities and a thin periodontal phenotype, multi-disciplinary treatment that includes PAOO could be effective, and could improve both the quality and safety of orthodontic-orthognathic therapy.

show abstract

Combined Orthodontic-Orthognathic Approach for Dentofacial Deformities as a Risk Factor for Gingival Recession: A Systematic Review

Cited by 4 publications

References 38 publications

Papilla reconstruction for an iatrogenic RT3 gingival defect using a tuberosity soft tissue graft: A case report

Papilla reconstruction for an iatrogenic RT3 gingival defect using a tuberosity soft tissue graft: A case report

Exploring the relationship between the number of systematic reviews and quality of evidence: an orthognathic surgery-based study

Multi-disciplinary treatment of maxillofacial skeletal deformities by orthognathic surgery combined with periodontal phenotype modification: A case report

Contact Info

Product

Resources

About