Gingival labial recessions in orthodontically treated and untreated individuals: a case - control study. Renkema AM, Fudalej PS, Renkema AA, Abbas F, Bronkhorst E, Katsaros C. J ClinPeriodontol. 2013; 40(6):631-7
To consider orthodontic treatment as one of the aetiologic factors of gingival recessions is still controversial. However, it is suggested that excessive lingual or labial tooth movements make bone plates thinner, followed by marginal gingival apical migration and root exposures could be produce. Renkeman et al. performed a case-control study evaluating retrospectively the long-term development of labial gingival recessions in orthodontic patients during active treatment and retention phase, compared with untreated individuals. The presence of gingival recession (yes or no) was identified in the study casts from 100 patients and 120 controls at different times, approximately 12, 15, 18 and 21 years of age (T12 pretreatment, T15 end of treatment , T18 long- term, T21 long term, respectively). Recession was considered as the labial exposure of the cemento-enamel junction. Data collection was standardized and observers were calibrated. They found that gingival recesions were higher in treated cases than in controls, finding that lower teeth were more vulnerable. The odds ratio for the occurrence of gingival recession in these cases compared with controls was 4.48, considering orthodontic treatment as a risk factor for the development of buccal gingival recessions. The initial position, amount of proclination, the appliance itself and type of retention have a great effect on the occurrence of gingival recession in the lower incisors. Furthermore, orthodontic appliances and fixed retention are associated to an increase in plaque accumulation that may lead to gingival inflammation, and could result in the development of gingival recessions. However, the method used by the authors should be complemented with more detailed clinical evaluations such as diet, hygiene habits, smoking and ethnicity to obtain more specific results. Review authors: Franz Willman Chiguala Mixan, Albina Karen Vergaray Solano.