Kasaj A Definition of gingival recession and anatomical considerations. In: Kasaj A Springer2018
Patel M, Nixon PJ, Chan MF Gingival recession: Part 1. Aetiology and non-surgical management. Br Dent J. 2011; 211:251-254 https://doi.org/10.1038/sj.bdj.2011.764
Meade MJ, Weir T, Seehra J, Fleming PS Clear aligner therapy practice among orthodontists in the United Kingdom and the Republic of Ireland: a cross-sectional survey of the British Orthodontic Society membership. J Orthod. 2024; 51:120-129
Chen I, Chung J, Vella R Alterations in subgingival microbiota during full-fixed appliance orthodontic treatment - a prospective study. Orthod Craniofac Res. 2022; 25:260-268 https://doi.org/10.1111/ocr.12534
Jiang Q, Li J, Mei L Periodontal health during orthodontic treatment with clear aligners and fixed appliances: a meta-analysis. J Am Dent Assoc. 2018; 149:712-720 https://doi.org/10.1016/j.adaj.2018.04.010
Lu H, Tang H, Zhou T, Kang N Assessment of the periodontal health status in patients undergoing orthodontic treatment with fixed appliances and Invisalign system: a meta-analysis. Medicine (Baltimore). 2018; 97 https://doi.org/10.1097/md.0000000000010248
Wu Y, Cao L, Cong J The periodontal status of removable appliances vs fixed appliances: a comparative meta-analysis. Medicine (Baltimore). 2020; 99 https://doi.org/10.1097/md.0000000000023165
Rossini G, Parrini S, Castroflorio T Periodontal health during clear aligners treatment: a systematic review. Eur J Orthod. 2015; 37:539-543 https://doi.org/10.1093/ejo/cju083
Greer A, Murray AM, Vere JW Periodontal exams for adult orthodontic patients. Orthod Update. 2018; 11:145-149
Madariaga ACP, Bucci R, Rongo R Impact of fixed orthodontic appliance and clear aligners on the periodontal health: a prospective clinical study. Dent J (Basel). 2020; 8 https://doi.org/10.3390/dj8010004
Papageorgiou SN, Papadelli AA, Eliades T Effect of orthodontic treatment on periodontal clinical attachment: a systematic review and metaanalysis. Eur J Orthod. 2018; 40:176-194 https://doi.org/10.1093/ejo/cjx052
Rouzi M, Zhang X, Jiang Q Impact of clear aligners on oral health and oral microbiome during orthodontic treatment. Int Dent J. 2023; 73:603-611 https://doi.org/10.1016/j.identj.2023.03.012
Han JY A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis. J Periodontal Implant Sci. 2015; 45:193-204
Li Y, Xiao S, Jin Y Stress and movement trend of lower incisors with different IMPA intruded by clear aligner: a three-dimensional finite element analysis. Prog Orthod. 2023; 24 https://doi.org/10.1186/s40510-023-00454-7
Papageorgiou SN, Koletsi D, Iliadi A Treatment outcome with orthodontic aligners and fixed appliances: a systematic review with meta-analyses. Eur J Orthod. 2020; 42:331-343 https://doi.org/10.1093/ejo/cjz094
Johal A, Bondemark L Clear aligner orthodontic treatment: Angle Society of Europe consensus viewpoint. J Orthod. 2021; 48:300-304 https://doi.org/10.1177/14653125211006423
Misch KA, Yi ES, Sarment DP Accuracy of cone beam computed tomography for periodontal defect measurements. J Periodontol. 2006; 77:1261-1266 https://doi.org/10.1902/jop.2006.050367
Alsulaimani L, Qali M Relationship between cone-beam CT evaluation and clinical evaluation before and after orthodontic treatment and the rate of gingival recession: a systematic review. Cureus. 2024; 16 https://doi.org/10.7759/cureus.62536
Fixed appliances are an excellent treatment approach for mild to severe malocclusions. Increasingly, aligner-based treatments are being provided as a treatment option. The latter may be preferable to fixed appliances in selected cases. A young adult with severe gingival recession is presented who was treated successfully with aligner-based treatment with minimal deterioration of the gingival tissue levels. However, limits should be applied to the buccal and labial movement of teeth to reduce the risk of worsening of the gingival recession.
CPD/Clinical Relevance:
Aligner-based treatment may be preferable for orthodontic patients with severe gingival recession.
Article
Gingival recession occurs when the keratinized gingiva is displaced apically, exposing the root surfaces.1 The aetiology of gingival recession can be a result of mechanical and physical factors or inflammatory processes.2 Mechanical and physical causes include vigorous tooth brushing, traumatic occlusion, trauma from foreign bodies, teeth displaced out of the line of the arch and aberrant frenal attachments. Inflammatory processes causing gingival recession can be seen with thin gingival biotype, periodontal disease and orthodontic tooth movement.
Orthodontic tooth movement per se does not cause recession. However, if teeth are moved labially outside the envelope of the alveolar bone, this will result in loss of buccal bone and a decrease in gingival tissue thickness because of the stretching of the gingivae.3
Orthodontic treatment aims to align teeth and correct malocclusions, improving facial aesthetics and overall oral health. Two different types of orthodontic appliances are commonly used to achieve these goals: traditional fixed appliances using the pre-adjusted edgewise system,4 and clear aligners, which are now provided as a treatment option by most orthodontists in the UK and Republic of Ireland.5
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