Influence of Periodontal Biotype on Root Surface Exposure During Orthodontic Treatment: A Preliminary Study

Abstract

Aim: To evaluate the long-term outcomes of Acellular Dermal Matrix (ADM) with Coronally Advanced Flap (CAF) or Tunnel technique (TUN) in the treatment of multiple adjacent gingival recessions (MAGRs). Material and methods: Nineteen of the original 24 patients contributing to a total number of 33 sites for CAF and 34 for TUN were available for the 12 years follow-up examination. Recession depth, mean root coverage (mRC), keratinized tissue width (KTW), gingival thickness (GT) were evaluated and compared with baseline values and 6-months results. Regression analysis was performed to identify factors related to the stability of the gingival margin. Results: A highly significant drop in mRC was observed for both groups from the 6 months timepoint to the 12 years recall (p < .001). While there were no statistically significant differences between the two groups in terms of Clinical Attachment Level (CAL), KTW, GT changes and Root Coverage Esthetic Score at each timepoint (p > .05). KTW ≥ 2 mm and GT ≥ 1.2 mm at 6-months were two predictors for stability of the gingival margin (p = .03 and p = .01, respectively). Conclusions: A significant relapse of the gingival margin of MAGRs treated with CAF or TUN + ADM was observed after 12 years.

Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions

“…Authors report an increase of the prevalence up to 47% in long‐term observations (5 years) . One study reported a correlation between lower incisor proclination and thin phenotype Direction of the tooth movement and the bucco‐lingual thickness of the gingiva may play important roles in soft tissue alteration during orthodontic treatment …”

Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations

“…The authors scored GT as thin, medium, or thick. Recently, a color‐coded probe was proposed to identify four gingival biotypes (thin, medium, thick and very thick) …”

“…GT can be measured with different approaches, as reported previously. To date, a reproducible, and easy approach is observing a periodontal probe detectable through the soft tissues after being inserted into the sulcus …”

Correlation between periodontal soft tissue and hard tissue surrounding incisors in skeletal Class III patients

“…1 When the gingival biotype is thin, orthodontic tooth movements may be considered unfavorable, increasing the risk of gingival recession. 2 Melsen and Allais 3 found significant correlations between keratinized gingival width, gingival biotype, and the development of or increase in gingival recession.…”

“…However they have focused mainly on the buccal plate of maxillary anterior teeth. 2,[12][13][14][15][16] To the best of the authors' knowledge, no studies have investigated the relationships between soft tissue biotypes and the buccolingual alveolar structures, particularly in patients with skeletal Class III malocclusion.…”