The Periodontal Benefit of Orthodontic Tooth Movement in a Deep Facial Recession of a Mandibular Incisor

Abstract

Gingival recession refers to the exposure of the tooth's surface by an apical shift of the gingiva. The aim of this paper is to present a clinical case of an adult patient with a skeletal Class I and clinically deep gingival recession in the mandibular left central incisor. A preadjusted appliance with 0.022 in × 0.028 in slot was placed in both arches. Rectangular arches were used, with the addition of root lingual torque, specifically in the left lower central incisor. Class II and vertical intermaxillary elastics were used throughout the active treatment to obtain intercuspation of the posterior teeth. The orthodontic movement with the application of a localized biomechanics system of forces into the mandibular left central incisor delivered good dental and functional occlusion and, mainly, gingival and periodontal health. The follow-up showed stable results with the periodontium within normal limits and an improved occlusal interdigitation.

Effectiveness of Invisalign® aligners in the treatment of severe gingival recession: A case report

“…On the other hand, repositioning of the root into the alveolar process by means of orthodontic appliances can result in a better marginal bone level and a spontaneous reduction in GR. 1 , 8 , 13 - 15 The tomographic images of our patient showed the beneficial effects of the clear aligners on her periodontal health. Before treatment initiation, the patient was aware of the poor positioning of tooth #41 as well as the failure of the gingival graft surgeries previously performed for root coverage.…”

“…Proper repositioning of the tooth inside the alveolus by means of orthodontic movement has been reported to have beneficial effects on the periodontium 1,8,14,15 and, consequently, bone regeneration. 14 Laursen et al 13 presented a series of 12 patients with GR on the buccal or lingual surfaces of the mandibular incisors, which showed poorly positioned roots.…”

“…Bone dehiscence is an anatomical prerequisite for GR development. 1 - 4 Periodontal disease, mechanical trauma, a thin gingival biotype, traumatic occlusion, and aging are possible etiological factors for GR. 3 , 4 …”

“…Bone dehiscence is an anatomical prerequisite for GR development. [1][2][3][4] Periodontal disease, mechanical trauma, a thin gingival biotype, traumatic occlusion, and aging are possible etiological factors for GR. 3,4 Orthodontic movements without buccal or lingual control increase the risk of bone dehiscence, which can cause GR.…”

Clear Aligner Treatments in Orthoperio Patients

“…Afterwards, during the second series of aligners, the minimal movement of lower canines was planned, with extremely low reactive forces on adjacent teeth. Additionally, adequate staging of dental movements, accurate tip correction, extrusion of 3.2, and increase of lingual torque of 3.3 and 4.3 have redesigned the gingival smile line allowing for an improvement of recessions and better aesthetics [ 19 , 20 ].…”