Practical application of a method for assessing the progression of gingival recessions in orthodontically treated patients--a pilot study.

AIMS: The objective of the present study was to discuss the practical application of a new method for measuring bone width in the anterior section of the mandible to assess the progression of gingival recessions after orthodontic treatment based on a description of case studies.

METHODS: Three cases with skeletal classes I, II and III aged 20-29 were presented. We assessed the risk of gingival recessions around lower incisors by analysing cephalograms before and after orthodontic treatment. The following values were analysed: the angle of buccal bone thickness in the anterior section of the mandible (API-CEJ2-B), the height of bone dehiscence (CEJ2-Id) and the width of the mentalis (B-D). Recession height (RD) and width (RW) were clinically measured using calibrated 1mm periodontometer.

RESULTS: The mean baseline angle of API-CEJ2-B[°] was 22.23° before and no lower than 16° after treatment. In all patients CEJ2-Id was 0.56 mm before and greater than 1.4 mm following treatment. This was reflected clinically in the absence of new gingival recessions or the progression of an already existing recession in the area of the lower incisors in the first two cases. In the third case, height of recessions was increased to 1.25 mm average value. The mean baseline width for B-D was 13.46 mm; in all cases it increased up to 14.5 mm after treatment, most significantly in the case of a female patient with skeletal class II.

CONCLUSIONS: An analysis of cephalometric images, including basic cranio- and gnathometric measurements together with a careful assessment of bone, mucosal and dental parameters of the alveolar ridge, can be a useful instrument to determine the risk of gingival recessions and to choose the right orthodontic treatment option, ensuring the highest possible aesthetic-functional treatment outcome.