Gingival recessions of lower incisors after proclination by orthodontics alone or in combination with anterior mandibular alveolar process distraction osteogenesis

Antonarakis, Gregory S.; Joss, Christof Urs; Triaca, Albino; Kuijpers-Jagtman, Anne Marie; Kiliaridis, Stavros

doi:10.1007/s00784-017-2056-8

Cited by 17 publications

(7 citation statements)

References 34 publications

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“…Looking specifically at lower incisors, very little has been published so far. Nevertheless, the present magnitude (mean 0.0-0.1 mm, maximum 1.0 mm) is similar or lower than in class II:1 patients after Herbst-MBA Tx (mean 0.1-0.2 mm, maximum 4.0 mm [18]) respectively in other samples of orthodontically treated patients observed for 4-9 years where the values in the literature range between ≈ 0.6 mm [41], 0.6-1.1 mm [12] and 0.9-1.0 mm [42]. This is also true for the corresponding values determined from an orthodontically untreated sample (mean 1.0-1.2 mm, maximum 3.0 mm [29]).…”

Section: Results-magnitudesupporting

confidence: 45%

Class II:2 malocclusion—prevalence and progression of labial gingival recessions during Herbst-Multibracket appliance treatment

Bock

Killat²,

Ruf

2020

Clin Oral Invest

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Objectives To determine the prevalence, incidence, and changes in magnitude of labial gingival recessions (LGR) in class II:2 patients during Herbst-Multibracket appliance (Herbst-MBA) treatment (Tx) plus retention. Subjects and methods All class II:2 patients of the Department of Orthodontics, University of Giessen, Germany who completed Herbst-MBATx (mean pre-Tx age 15.6 years). The cohort had undergone a Herbst phase (mean 8.1 months) as well as a subsequent MBA phase (mean 14.4 months). Study casts were evaluated from pre-Tx and after Herbst-MBA Tx plus ≥ 24 months of retention. Results Ratable pre-Tx and post-retention study casts (total observation period 53.5 ± 10.3 months) were available from 94 out of 173 patients. No significant difference existed regarding pre-Tx LGR data between patients with and without complete records. The prevalence for teeth with LGR ≥ 0.5 mm was 1.4% pre-Tx respectively 6.7% post-retention. The highest values of up to 5.3% (pre-Tx) and 20.2% (post-retention) were determined for the upper first premolars and lower central incisors. Incidence values of 4.7% (all teeth) and up to 14.9% (upper first right premolars) respectively 11.1% (lower central incisors) were calculated (LGR ≥ 0.5 mm). The overall LGR mean magnitudes were 0.01 mm pre-Tx respectively 0.06 mm post-retention. Conclusions For the prevalence of LGR ≥ 0.5 mm an average increase of 5.3% was determined during ≈ 4.5 years of Herbst-MBA Tx plus retention. The highest incidence was seen for lower central incisors and upper right premolars (11.1/14.9%). The overall LGR mean magnitude increased by 0.05 mm. Clinical relevance Herbst-MBA Tx is a common approach for class II:2 malocclusions. Very little, however, is known regarding LGR development in respective patients.

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Section: Results-magnitudesupporting

confidence: 45%

Class II:2 malocclusion—prevalence and progression of labial gingival recessions during Herbst-Multibracket appliance treatment

Bock

Killat²,

Ruf

2020

Clin Oral Invest

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“…The initial tooth displacement due to orthodontic force determines, especially in the early stages of OTM [2,4], the increase of stress in the periodontal ligament which determines the osteogenic response of the alveolar bone responsible for the subsequent tissue remodeling [7,8,9]. This could result in a significant reduction in the speed of OTM and in related phenomena such as in gingivitis, dental ankyloses, and root resorption [10,11,12].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Low-Level Laser Therapy during Tooth Movement: A Randomized Clinical Trial

et al. 2019

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The present study evaluated the effects of low-level laser therapy (LLLT) by means of a diode laser in accelerating orthodontic tooth movement (OTM). After extraction of the first upper premolars for orthodontic purpose, 82 maxillary canines which needed distalization were analyzed in 41 enrolled patients (21 males, 20 females, mean age 13.4 ± 2.1 years). On all experimental sites, an orthodontic force of 50/N was applied by a nickel-titanium (NiTi) closed coil spring (G&H, Franklin, IN, USA) in order to obtain the space closure. Using a split mouth randomized design, the test side was treated using a diode laser (Wiser Laser Doctor Smile, Brendola, Italy) operating at 810 nm wavelength in continuous wave mode at both the buccal and palatal side on three points/side (distal, medial and mesial) (1 W output power, continuous wave of 66.7 J/cm2, energy density of 8 J) at baseline and at 3, 7, and 14 days and every 15 days until the space closed. On the control side, the opposite selected canine was treated only using orthodontic traction. The primary outcome chosen was the overall time needed to complete the levelling and closing space, measured on a study cast. The secondary outcome chosen was the evaluation of pain levels related to tooth traction, using a Visual Analogue Scale (VAS), recorded at 3, 7, and 14 days after treatments. The mean space closures of the maxillary canines were comparable between groups [Test, 4.56 mm (95% CI 3.9–4.8); Control, 4.49 mm (95% CI 3.8–4.7), p = 0.456]. The laser group yielded less mean time [84.35 ± 12.34 days (95% CI 79.3–86)] to accomplish space closure compared to the control group [97.49 ± 11.44 days (91.7–102.3)] (p < 0.001). The test side showed a significant reduction in the average range of dental pain at 3 [Test, 5.41 (95% CI 5.1–5.6); Control, 7.23 (95% CI 6.9–7.6), p < 0.001], 7 [Test, 4.12 (95% CI 3.8–4.7); Control, 5.79 (95% CI 5.4–5.8), p < 0.001], and at 14 days [Test, 2.31 (95% CI 1.8–2.3); Control, 3.84 (95% CI 3.3–4.2), p < 0.001] after treatment (p < 0.001). This study demonstrates that the use of LLLT therapy was effective in accelerating tooth movement and reducing pain levels related to OTM.

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“…The correlation between incisor inclination and their crown length was statistically significant (p = 0.027), which agrees with the results from the present study. Antonarakis et al [3] followed 55 patients over an average of 4.5 years after orthodontic treatment, reporting an increase in the labial gingival recessions. Multiple regression analysis showed that younger individuals, girls, and patients with greater incisor proclination were at higher risk of recession.…”

Section: Discussionmentioning

confidence: 99%

Postorthodontic lower incisor and canine inclination and labial gingival recession in adult patients

2020

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Purpose The goal was to determine whether changes in the inclination of lower incisors and canines upon orthodontic treatment with fixed appliances poses a threat for labial gingival recession in adult patients. Methods The sample of this prospective clinical trial consisted of 32 adult patients (mean age 25.08 ±6.50 years) treated with fixed appliances. Plaque and bleeding indices, probing pocket depth, clinical attachment level, gingival recession height (GR) and width (GRW), gingival thickness (GT), and keratinized tissue width were clinically recorded, while cone beam computed tomography (CBCT) was used to evaluate teeth inclination before (T1) and after treatment (T2). Oral hygiene, brushing habits, and smoking were controlled. Results During orthodontic treatment on 15 (8.33%) teeth (10 incisors and 5 canines), spontaneous complete improvement of pre-existing GR was observed. On 2 incisors, GR decreased and on 3 teeth GR did not change. Moreover, 1 incisor presented an increased GR, while 2 teeth developed new defects. Mean GR, GRW, and GT decreased significantly only on the incisors. Proclination of incisors and canines during treatment (compared with retroclination of the teeth) implicated a lower reduction in GR at T2: 0.19 mm (p = 0.034) and 0.18 mm (p = 0.037), respectively. Multiple regression analysis confirmed that more tooth proclination was associated with a higher risk for an increase in GR (p < 0.00). Conclusion Properly planned changes in lower incisor and canine inclination can be carried out in adult patients without posing a high risk to labial gingival recessions if the individual periodontal biotype is respected. The reported outcomes underscore the orthodontic principle to keep tooth roots inside the alveolar bone.

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Gingival recessions of lower incisors after proclination by orthodontics alone or in combination with anterior mandibular alveolar process distraction osteogenesis

Abstract: During orthodontic treatment, with or without DO, one should avoid proclining lower incisors more than 10° to decrease the risk of gingival recessions.

Cited by 17 publications

References 34 publications

Class II:2 malocclusion—prevalence and progression of labial gingival recessions during Herbst-Multibracket appliance treatment

Class II:2 malocclusion—prevalence and progression of labial gingival recessions during Herbst-Multibracket appliance treatment

Effectiveness of Low-Level Laser Therapy during Tooth Movement: A Randomized Clinical Trial

Postorthodontic lower incisor and canine inclination and labial gingival recession in adult patients

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