Gingival Recessions in Orthodontically Treated and Untreated Adult Patients

Gingival Recessions in Orthodontically Treated and Untreated Adult Patients: a Prospective Study

To identify the predisposing parameters for gingival recessions in adult patients seeking orthodontic treatment. The ultimate aim is to provide a clinical guideline to estimate the risk of developing post-orthodontic gingival recessions.

The etiology of gingival recessions is yet to be fully understood and is very likely multifactorial, with the involved parameters not necessarily acting simultaneously or in equal extent. The most common etiologic factor would be dental plaque accumulation followed by traumatic tooth brushing, areas with thin, minimal or no keratinized tissue, smoking, malocclusion, dental trauma and high frenal attachment. The labial aspect of the mandibular incisors and maxillary molars is the most often affected by gingival recessions. These contributing factors identified in literature could be grouped in six main categories: age-related, population-related, site-related, mechanical factors, periodontal condition and iatrogenic factors, like orthodontic treatment.

Although quantifying the influence of each factor is very difficult, the association between gingival recessions and orthodontic treatment as an iatrogenic factor has been repeatedly suggested. Given the increasing amount of adult patients seeking orthodontic treatment, the aim of this study is to identify the predisposing parameters for gingival recessions in adult patients, seeking orthodontic treatment. The ultimate aim is to provide a clinical guideline to estimate the risk of developing post-orthodontic gingival recessions.

Inclusion Criteria:

• Patients with or without previous history of orthodontic treatment with and without gingival recessions
• ≥ 18 years old
• American Society of Anesthesiologists Classification I or II

Exclusion criteria:

• Patients with history of periodontal disease
• taking the following medication: anticoagulants, phenytoin, cyclosporine, nifedipine or calcium channel blockers
• Patients with prior history of radio or chemotherapy
• Pregnant or breastfeeding patients
• Patients with agenesis of one or more lower incisors

Exclusion Criteria:

Patients with history of periodontal disease Patients taking the following medication: anticoagulants, phenytoin, cyclosporine, nifedipine or calcium channel blockers Patients with prior history of radio or chemotherapy Pregnant or breastfeeding patients Patients with agenesis of one or more lower incisors