Effects of mandibular orthognathic treatment on mucogingival tissues

Twenty-four patients receiving comprehensive orthognathic care including genioplasty were studied to evaluate the effect of orthognathic treatment on the mucogingival complex in the mandibular anterior region. Parameters measured prior to and after therapy were: width of keratinized gingiva, width of attached gingiva and gingival recession. A subjective assessment of tissue thickness was accomplished. A statistically significant decrease in width of both keratinized and attached gingiva was noted following orthognathic therapy in the mandibular anterior area. In six of 24 patients, gingival recession was a clinically significant finding. The actual pretreatment width of keratinized and/or attached tissue did not seem to be the critical factor in development of recession. Risk of recession appeared to increase when genioplasty was combined with mandibular advancement and tended to occur at sites in which the keratinized gingiva and underlying bone appeared thin.