The impact of orthodontic treatment on gingival recession: prevention and therapeutic strategies

Gingival recession, defined as the apical migration of the gingival margin relative to the cementoenamel junction, is a noteworthy complication associated with orthodontic treatment. Its prevalence ranges from 3% to 38% among orthodontically treated patients and is influenced by multiple factors, including treatment mechanics, individual periodontal phenotype, and oral hygiene. The buccal surfaces of maxillary and mandibular teeth are particularly susceptible to post-treatment recession. Contributing factors include the application of excessive or improperly distributed orthodontic forces, tooth movement into areas with thin periodontal tissue, and plaque accumulation around orthodontic appliances. Effective prevention and management of gingival recession require a multidisciplinary approach. Key preventive strategies include comprehensive pre-treatment periodontal assessment, applying light and controlled forces, and strict oral hygiene maintenance during treatment. Post-treatment monitoring is essential for early detection and timely intervention. In cases where significant gingival recession develops, mucogingival surgical techniques, such as coronally advanced flaps or connective tissue grafts, offer predictable outcomes for the reconstruction of gingival tissues and stabilizing periodontal health. Collaboration between orthodontists and periodontists is crucial to optimize functional and aesthetic outcomes and ensure long-term stability of the dento-periodontal complex. Tailored treatment planning and early clinical intervention represent the cornerstone of successful orthodontic therapy with minimal periodontal risk.