Guided Bone Regeneration of a Pronounced Gingivo‐Alveolar Cleft Due to Orthodontic Space Closure

Abstract

The present paper illustrates an additional application for the guided bone regeneration technique.

Pilot study on orthodontic space closure after guided bone regeneration

“…As a consequence, there can be increased marginal bone loss in the spaces between neighboring teeth, a reduction in interdental bone height, and increased time necessary for the orthodontic space to close [16]. It sometimes becomes impossible to close the remaining spaces completely due to pronounced gingival invagination [7]. Spontaneous improvement is seldom, although one cannot generalize [9].…”

“…In der Folge kann es zu einem vermehrten marginalen Knochenverlust an den die Lücken begrenzenden Zähnen, zu einer Reduktion der interdentalen Knochenhöhe und zu einem erhöhten Zeitaufwand beim orthodontischen Lückenschluss kommen [16]. In einigen Fällen ist es auf Grund der Ausprägung sogar nicht mehr möglich, die Restlü-cken vollständig zu schließen [7]. Selten wurde eine spontane Verbesserung der Befunde beobachtet, was aber nicht verallgemeinert werden kann [9].…”

Healing processes following tooth extraction in orthodontic cases

“…Some authors suggest that, for the affected sites, the transeptal fibers are disorganized and not regenerating 57 , since the invagination is developing passively by the folding of the gingival tissues; histological studies have demonstrated the presence of an epithelial hypoplasia, while the connective tissues present with a decrease in collagen and an increase in glycoaminoglycanes. Another hypothesis concerning the origin of these fissures is that there is a break in the gingival fibers, followed by a pathological bone remodeling with loss of the cortical bone 42 . Gingival clefts are most frequently located on the buccal surfaces of the mandible (Fig.…”

“…The anatomical configuration of these gingival clefts contributes to the problem of cleaning the extraction site and predisposes the area to an increase in the plaque index. Therefore, it is recommended that the practitioner surgically treats these spaces and possibly use regeneration techniques 42 . Figure 5 The development of severe gingival fissures on the mandible in this patient who underwent a planned extraction protocol, in the course of orthodontic levelling.…”

“…A case report described the use of guided tissue regeneration for these cases of gingivo-osseous clefts after orthodontic closing of space 42 .…”