Gingival margin alterations and the pre-orthodontic treatment amount of keratinized gingiva

Abstract

The purpose of this retrospective study was to associate the amount of keratinized gingiva present in adolescents prior to orthodontic treatment to the development of gingival recessions after the end of treatment. The sample consisted of the intra-oral photographs and orthodontic study models from 209 Caucasian patients with a mean age of 11.20 +/- 1.83 years on their initial records and 14.7 +/- 1.8 years on their final records. Patients were either Angle Class I or II and were submitted to non-extraction orthodontic treatment. Gingival recession was evaluated by visual inspection of the lower incisors and canines as seen in the initial and final study models and intra-oral photographs. The amount of recession was quantified using a digital caliper and the observed post-treatment gingival margin alterations were classified as unaltered, coronal migration of the gingival margin or apical migration of the gingival margin. The width of the keratinized gingiva was measured from the mucogingival line to the gingival margin on the pre-treatment photographs. The teeth that developed gingival recession and those that did not have their gingival margin position changed did not differ in relation to the initial amount of keratinized gingiva (3.00 +/- 0.61 and 3.5 +/- 0.86 mm, respectively). Paradoxically, teeth that presented a coronal migration of the gingival margin had a smaller initial amount of keratinized gingiva (2.26 +/- 0.31 mm). The mean amount of initial keratinized gingiva did not predispose lower incisors and canines to gingival recession.

An evaluation of the gingival biotype and the width of keratinized gingiva in the mandibular anterior region of individuals with different dental malocclusion groups and levels of crowding

“…Closs et al26 investigated the relationship between the initial WKG and gingival recession by examining 209 subjects treated with fixed orthodontic appliances, and concluded that no significant difference existed in the initial WKG for individuals who did or did not have gingival recession. However, it is important to note that, in this study, the mean WKG of all teeth was greater than 2 mm.…”

Treatment of anterior crossbite and its influence on gingival recession

“…Closs et al 9 found no relationship between these variables: during lingual or labial movement of the crown, the authors observed an increase in gingival width even when little keratinized gingiva was present.…”

“…However, some authors claim that recession increases when there is proclination of the lower incisors, even in the presence of adequate keratinized gingiva width 9 . Conversely, other authors have found no correlation between these variables 10 .…”

Effect of gingival biotype on orthodontic treatment-induced periodontal complications: A systematic review

“…It should be noted that the recession (<2 mm) reported in some studies is usually not progressive and might be related to the heterogeneity of tissue quality. 55,[70][71][72] If gingival recession is observed after the orthodontic therapy, the treatment alternatives depend on its severity 73 and the probability of elimination by orthodontic intervention (Figure 3). It should also be kept in mind that the clinical relevance of the induced recession is unclear, and most studies have only documented the pre-or post-orthodontic incidence of gingival recession.…”