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Gingival recessions of lower incisors after proclination by orthodontics alone or in combination with anterior mandibular alveolar process distraction osteogenesis

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Abstract

Objectives

The aim of this study was to longitudinally compare periodontal conditions in consecutive patients who had orthodontic treatment with proclination of lower incisors either by orthodontics alone or in combination with anterior mandibular alveolar process distraction osteogenesis (DO).

Materials and methods

Nineteen patients had orthodontic treatment with DO, 18 with extraction of lower premolars (Ex), and 18 without extractions (Nonex). Lateral cephalograms were used to evaluate lower incisor proclination, while study casts and intraoral photographs were used to evaluate labial and lingual gingival recessions before (T1) and at an average of 4.5 years (T2) after treatment.

Results

No differences in labial recessions on lower incisors were present between the patient groups despite greater lower incisor proclination in the Nonex and DO groups. The Ex group showed no new development of lingual recessions in contrast to the Nonex (eight sites; two subjects) and DO groups (seven sites; three subjects). Severe lingual recessions (increased ≥1 mm) were more present in the Nonex group (five sites; two subjects) compared to the Ex group (no sites). Proclination of lower incisors of 10° or more either by orthodontic tooth movement or displacement of the whole alveolar process increased the risk of lingual gingival recessions 17 times. This was not the case with labial gingival recessions.

Conclusions

Orthodontic or surgical proclination of lower incisors beyond a 10° limit increases the risk of inducing lingual gingival recessions.

Clinical relevance

During orthodontic treatment, with or without DO, one should avoid proclining lower incisors more than 10° to decrease the risk of gingival recessions.

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Acknowledgements

The authors would like to acknowledge Dr. Michele Antonini, the orthodontist who treated the patients in the present study, who sadly passed away a few years ago.

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Authors and Affiliations

  1. Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland

    Gregory S. Antonarakis, Christof Urs Joss & Stavros Kiliaridis

  2. Department of Orthodontics and Craniofacial Biology, Radboud university medical center, Nijmegen, The Netherlands

    Christof Urs Joss & Anne Marie Kuijpers-Jagtman

  3. Pyramide Klinik, Zürich, Switzerland

    Albino Triaca

Authors
  1. Gregory S. Antonarakis
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  2. Christof Urs Joss
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  3. Albino Triaca
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  4. Anne Marie Kuijpers-Jagtman
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  5. Stavros Kiliaridis
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Corresponding author

Correspondence to Gregory S. Antonarakis.

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Conflict of interest

All authors declare that they have no conflicts of interest.

Funding

No funding was obtained for the present research.

Ethical approval

Ethical approval was obtained from the Ethics Committee of the Canton of Zürich, Switzerland (number 593). All subjects provided written informed consent. All procedures performed were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all individual participants included in the study.

Additional information

Gregory S. Antonarakis and Christof Urs Joss contributed equally to this work.

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Antonarakis, G.S., Joss, C.U., Triaca, A. et al. Gingival recessions of lower incisors after proclination by orthodontics alone or in combination with anterior mandibular alveolar process distraction osteogenesis. Clin Oral Invest 21, 2569–2579 (2017). https://doi.org/10.1007/s00784-017-2056-8

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  • DOI: https://doi.org/10.1007/s00784-017-2056-8

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