The regeneration of gingiva: its potential value for the recession of healthy gingiva

The Periodontal Benefit of Orthodontic Tooth Movement in a Deep Facial Recession of a Mandibular Incisor

Gingival recession refers to the exposure of the tooth's surface by an apical shift of the gingiva. The aim of this paper is to present a clinical case of an adult patient with a skeletal Class I and clinically deep gingival recession in the mandibular left central incisor. A preadjusted appliance with 0.022 in × 0.028 in slot was placed in both arches. Rectangular arches were used, with the addition of root lingual torque, specifically in the left lower central incisor. Class II and vertical intermaxillary elastics were used throughout the active treatment to obtain intercuspation of the posterior teeth. The orthodontic movement with the application of a localized biomechanics system of forces into the mandibular left central incisor delivered good dental and functional occlusion and, mainly, gingival and periodontal health. The follow-up showed stable results with the periodontium within normal limits and an improved occlusal interdigitation.

Spontaneous improvement of gingival recession after correction of tooth positioning

A 30-year-old woman sought treatment for malpositioned mandibular incisors; the roots were positioned outside the alveolar bone, related to severe localized gingival recession. She had been previously treated orthodontically and subsequently underwent 2 gingival grafts. The new treatment included torquing the roots back within the alveolar bone and referral to a periodontist for a gingival graft. In this clinical report, the possible spontaneous improvement of gingival recession is discussed. A hypothesis described in the literature is called the "creeping attachment" phenomenon. The literature includes conflicting reports about the cause-and-effect relationship between orthodontics and gingival recession. This clinical example reports spontaneous improvement of gingival recession after correction of tooth positioning in the alveolar bone. A gingival graft can be performed after adequate root positioning in the alveolar bone housing, thus increasing the chance of achieving more favorable results.