A systematic review of the association between appliance-induced labial movement of mandibular incisors and gingival recession. 2011

Tehnia Aziz, and Carlos Flores-Mir
Division of Orthodontics, Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

OBJECTIVE To determine if an association exists between appliance-induced labial movement of mandibular incisors and gingival recession. METHODS Electronic databases were searched for studies with the terms: 'incisor', 'incisor proclination', 'tooth movement', 'orthodontic tooth movement', 'gingival recession' and 'orthodontic appliance'. The original articles and abstracts that met the initial inclusion criteria were retrieved, and their references hand searched for possible articles missed by the database searches. Inclusion criteria included human studies that suggested a link between labial movement of lower incisors produced by orthodontic treatment and gingival recession. Exclusion criteria included significant intrusion or extrusion of the mandibular incisors, periodontal disease, subjects taking medication that affects gingival health and subjects with systematic diseases. RESULTS Seven articles fulfilled the selection criteria. Gingival recession after labial movement of lower incisors was assessed on dental casts, intra-oral slides, lateral cephalograms and gingival examination. The articles were analysed to determine the impact of their treatment methodology on the outcomes. CONCLUSIONS No association between appliance-induced labial movement of mandibular incisors and gingival recession was found. Factors that may lead to gingival recession after orthodontic tipping and/or translation movement were identified as a reduced thickness of the free gingival margin, a narrow mandibular symphysis, inadequate plaque control and aggressive tooth brushing.

UI MeSH Term Description Entries
D007180 Incisor Any of the eight frontal teeth (four maxillary and four mandibular) having a sharp incisal edge for cutting food and a single root, which occurs in man both as a deciduous and a permanent tooth. (Jablonski, Dictionary of Dentistry, 1992, p820) Incisors
D008334 Mandible The largest and strongest bone of the FACE constituting the lower jaw. It supports the lower teeth. Mylohyoid Groove,Mylohyoid Ridge,Groove, Mylohyoid,Grooves, Mylohyoid,Mandibles,Mylohyoid Grooves,Mylohyoid Ridges,Ridge, Mylohyoid,Ridges, Mylohyoid
D009967 Orthodontic Appliances Devices used for influencing tooth position. Orthodontic appliances may be classified as fixed or removable, active or retaining, and intraoral or extraoral. (Boucher's Clinical Dental Terminology, 4th ed, p19) Appliance, Orthodontic,Appliances, Orthodontic,Orthodontic Appliance
D002508 Cephalometry The measurement of the dimensions of the HEAD. Craniometry
D003765 Models, Dental Presentation devices used for patient education and technique training in dentistry. Dental Models,Dental Model,Model, Dental
D005889 Gingival Recession Exposure of the root surface when the edge of the gum (GINGIVA) moves apically away from the crown of the tooth. This is common with advancing age, vigorous tooth brushing, diseases, or tissue loss of the gingiva, the PERIODONTAL LIGAMENT and the supporting bone (ALVEOLAR PROCESS). Gingival Atrophy,Atrophy of Gingiva,Gingiva Atrophies,Gingiva Atrophy,Gingival Atrophies,Gingival Recessions,Recession, Gingival,Recessions, Gingival
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014087 Tooth Movement Techniques Orthodontic techniques used to correct the malposition of a tooth or teeth. Tooth Depression,Tooth Intrusion,Tooth Movement, Minor,Tooth Uprighting,Orthodontic Tooth Movement,Depression, Tooth,Depressions, Tooth,Intrusion, Tooth,Intrusions, Tooth,Minor Tooth Movement,Minor Tooth Movements,Movement Technique, Tooth,Movement Techniques, Tooth,Movement, Orthodontic Tooth,Movements, Orthodontic Tooth,Orthodontic Tooth Movements,Technique, Tooth Movement,Techniques, Tooth Movement,Tooth Depressions,Tooth Intrusions,Tooth Movement Technique,Tooth Movement, Orthodontic,Tooth Movements, Minor,Tooth Movements, Orthodontic,Tooth Uprightings,Uprighting, Tooth,Uprightings, Tooth

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