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. 2025 Apr;52(4):589-598.
doi: 10.1111/jcpe.14097. Epub 2025 Jan 8.

Incidence of Gingival Recessions in Adolescent Orthodontic Patients Treated With Fixed Appliances and Lingual Retainer

Beatriz Celis  1   2 , Javier Sanz-Esporrin  3   4 , Carina Verdasco  1 , Rosa-Maria Yañez-Vico  1   2 , Conchita Martin  1   2
Affiliations

Incidence of Gingival Recessions in Adolescent Orthodontic Patients Treated With Fixed Appliances and Lingual Retainer

Beatriz Celis et al. J Clin Periodontol. 2025 Apr.

Abstract

Aim: To evaluate risk indicators for gingival recessions (GRs) in the lower anterior teeth of orthodontic patients post treatment and during a retention period of at least 5 years, compared to non-treated controls.

Material and methods: Eighty-nine orthodontically treated patients who were recession-free before treatment were recruited. Demographic, cephalometric and occlusal records were retrieved before (T1) and after treatment (T2), and periodontal outcomes were clinically evaluated at least 5 years post retention (T3). Eighty-eight non-treated patients served as controls. Recession areas were digitally assessed and compared using t-test and chi-square tests, and a multiple linear regression model was built.

Results: In the treated group, recession incidence was 11.24% at T2 and 67.42% at T3, all classified as type 1, class A (-). Among controls, recession prevalence was 15.91%, similar to the incidence at T2, but significantly lower than at T3. GR was most common in canines (1.85 mm2; 95% CI: 2.61-7.70; p < 0.005). Regression analysis identified higher incidence of recessions in female patients and in those with thin phenotype, high angle skeletal pattern, increased final inclination of lower incisors and greater probing depth.

Conclusions: GR incidence after orthodontic treatment was comparable to controls but increased significantly post retention. Several risk indicators may predict GR occurrence.

Keywords: fixed retainer; gingival recession; orthodontic retention; orthodontic treatment; risk indicator.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Study diagram. T1, before orthodontic treatment; T2, end of orthodontic treatment and T3, at least 5 years after treatment (retention phase). For the non‐exposed group, records were obtained during their pre‐orthodontic visit. Solid background indicates clinical assessment visit.
FIGURE 2
FIGURE 2
Example of recession area delimitation in the digital dental cast, verified against the corresponding clinical photograph. 1. Superimposition of the initial and final model in the Geomagic control program. 2. Image of the initial digital dental cast. 3a. Post‐retention clinical photograph showing recession of the lower incisors. 3b. Corresponding post‐retention digital dental cast showing recession of the lower incisors. 4a. Delimitation of the recession area (black dots) on the left central incisor. 4b. Calculation of the recession area on the digital dental cast of the left central incisor.
FIGURE 3
FIGURE 3
Bar diagram illustrating the analysis of recessions for each tooth individually and their progressive increase across the three study periods. T1, before orthodontic treatment; T2, end of orthodontic treatment and T3, at least 5 years after treatment (retention phase). 33, left mandibular canine; 32, left mandibular lateral incisor; 31, left mandibular central incisor; 41, right mandibular central incisor; 42, right mandibular lateral incisor; 43, right mandibular canine.
See this image and copyright information in PMC

References

    1. Aki, T. , Nanda R. S., Currier G. F., and Nanda S. K.. 1994. “Assessment of Symphysis Morphology as a Predictor of the Direction of Mandibular Growth.” American Journal of Orthodontics and Dentofacial Orthopedics 106, no. 1: 60–69. - PubMed
    1. Al‐Moghrabi, D. , Johal A., O'Rourke N., et al. 2018. “Effects of Fixed vs Removable Orthodontic Retainers on Stability and Periodontal Health: 4‐Year Follow‐Up of a Randomized Controlled Trial.” American Journal of Orthodontics and Dentofacial Orthopedics 154, no. 2: 167. 10.1016/j.ajodo.2018.01.007. - DOI - PubMed
    1. Aziz, T. , and Flores‐Mir C.. 2011. “A Systematic Review of the Association Between Appliance‐Induced Labial Movement of Mandibular Incisors and Gingival Recession.” Australasian Orthodontic Journal 27, no. 1: 33–39. - PubMed
    1. Cadenas de Llano‐Pérula, M. , Castro A. B., Danneels M., Schelfhout A., Teughels W., and Willems G.. 2023. “Risk Factors for Gingival Recessions After Orthodontic Treatment: A Systematic Review.” European Journal of Orthodontics 45, no. 5: 528–544. - PubMed
    1. Chatzopoulou, D. , and Johal A.. 2015. “Management of Gingival Recession in the Orthodontic Patient.” Seminars in Orthodontics 21: 15–26.

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