Post-Orthodontic Lower Incisors Recessions: Combined Periodontic and Orthodontic Approach

Area of Science:

• Dentistry
• Orthodontics
• Periodontics

Background:

• Bonded lingual retainers (BLRs) are used for orthodontic alignment but can cause gingival recession.
• Miller class III recession, characterized by root exposure, negatively impacts esthetics and comfort.

Purpose of the Study:

• To compare the effectiveness of two protocols for treating Miller class III gingival recession in patients with BLRs.
• To evaluate the impact of BLR removal on root coverage outcomes.

Main Methods:

• Fifteen patients with post-orthodontic Miller class III recession and BLRs were included.
• Two groups were compared: one with BLR removal before surgery and one without.
• All patients received a modified tunnel double papilla surgery for root coverage.

Main Results:

• The protocol involving BLR removal showed a significantly greater average improvement in recession depth (4.0 ± 0.83 mm, 87.2% improvement).
• The surgical-only protocol resulted in less improvement (1.88 ± 1.29 mm, 43.8% improvement).
• The difference in recession improvement between the two protocols was statistically significant (p = 0.008).

Conclusions:

• Removing the bonded lingual retainer prior to surgical root coverage is beneficial.
• This approach leads to more predictable and substantial root coverage for Miller class III recessions.
• Optimizing treatment for BLR-associated gingival recession improves patient outcomes.