Changes in Incisor Inclination Does Not Significantly Affect Amount of Gingival Recession
Gingival Recessions and the Change of Inlination of Mandibular Incisors During Orthodontic Treatment
Renkema AM, Fudalej PS, et al:
Eur J Orthod 2013; 34 (april) 249-255
Proclination or retroclination of mandibular incisors during orthodontic treatment has no statistically significant effect on the amount of gingival recession 5 years after treatment.
Article Reviewed: Gingival Recessions and the Change of Inclination of Mandibular Incisors During Orthodontic Treatment. Renkema AM, Fudalej PS, et al: Eur J Orthod; 2013;35 (April): 249-255.
Background: Many studies have examined the effects of orthodontic treatment on periodontal status. Overall, orthodontic treatment may have a slight negative effect of periodontal health, but conflicting evidence exists on how changes to incisor inclination affect gingival health.
Objective: To compare the amount of gingival recession that occurs when incisors are proclined, retroclined, or left unchanged during treatment.
Design: Retrospective study.
Participants: A total of 179 patients (77 males and 102 females) who began comprehensive orthodontic treatment at 11 to 14 years of age, had all 4 mandibular incisors, and had a fixed canine-to-canine mandibular retainer were included. All patients had records available from before treatment, after treatment, and 2 and 5 years after treatment.
Methods: Patients were divided into 3 groups based on the change in incisor inclination during treatment: (1) retroclined group (n=34), lower incisor inclination change was ≤–1° (range, –15° to –1°); (2) stable group (n=22), inclination did not change >–1°; or (3) proclined group (n=123), inclination change was >1° (range, 1.5° to 22.5°). The clinical crown height of each mandibular incisor was measured with digital calipers accurate to 0.01 mm. The changes in clinical crown height between the pretreatment casts and 5-year retention casts were compared among the 3 groups of inclination changes.
Results: Small interexaminer differences were seen, but were no more than 0.04 mm. The 3 groups were comparable in terms of age, treatment time, and the proportion of extraction cases. No gingival recession was seen prior to treatment. However, 5 years after treatment, recession was seen in 9% of the retroclined incisor patients, 5% of the stable inclination patients, and 16% of the proclined incisor patients; these differences were not statistically significant (P =0.27).
Conclusions: Changes to incisor inclination during orthodontic treatment did not significantly affect the amount of gingival recession seen 5 years following treatment.
Reviewer's Comments: Although statistical significance was not achieved, the proclination group did have 3 times the rate of recession compared to the stable inclination group. It would be interesting to study a larger sample size or to subdivide the proclined incisor group by gingival biotype to see if that influenced the statistical significance.(Reviewer–Brent E. Larson, DDS, MS).
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