Post-Orthodontic Lower Incisors Recessions: Combined Periodontic and Orthodontic Approach

• Published in: International journal of environmental research and public health Vol. 17; no. 21; p. 8060
• Main Authors: Beitlitum, Ilan, Barzilay, Vered, Rayyan, Fatma, Sebaoun, Alon, Sarig, Rachel
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02.11.2020; MDPI
• Subjects: Adult; Connective tissue; Enamel; Female; Follow-Up Studies; Gingiva; Gingival Recession - surgery; Humans; Incisor; Incisors; Male; Middle Aged; Orthodontics; Patients; Periodontics; Recession; Retention; Skin & tissue grafts; Surgery; Sutures; Teeth; Treatment Outcome; Wire; Young Adult; Chicago Illinois; Israel; Tel Aviv Israel; United States > US; root coverage; orthodontics; gingival recession; lingual retainer; connective tissue graft
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph17218060

The bonded lingual retainer (BLR) is considered a favorable choice for retaining lower incisors' alignment post-orthodontic treatment; however, it may cause some unwanted effects such as inadvertent tooth movement and torque changes. These often result in gingival recession (Miller class III-type) with exposure of the root surface, which compromises the esthetics and hinders the comfort of the patient. Fifteen post-orthodontic patients presenting Miller class III-type recessions with BLR were examined. Two protocols were used: the first included the removal of the BLR prior to surgery and the second included only a surgical approach. All patients underwent the same surgery of a modified tunnel double papilla procedure for root coverage. The gingival recession was measured using a dental probe before, and three to six months post-surgery. The average improvement in recession depth was significantly greater ( = 0.008) for the protocol that included removal of the BLR (4.0 ± 0.83 mm) with an improvement of 87.2% as compared to the second protocol that showed an improvement of 43.8% (1.88 ± 1.29 mm). Removing the BLR prior to surgery is beneficial for predictable root coverage in post-orthodontic Miller class III recessions.