Although commonly associated with periodontal disease and mechanical trauma, gingival recession may also intersect with orthodontic treatment planning and outcomes, particularly in adults with a thin periodontal phenotype.
Its prevalence increases with age and is compounded by hard tissue loss and alveolar bone dehiscence, making effective prevention and management a critical objective for multidisciplinary dental care teams.
Orthodontics, traditionally viewed through the lens of occlusal correction and esthetic alignment, plays a pivotal and increasingly recognized role in modulating periodontal health—specifically, in the prevention and management of gingival recession.
When meticulously planned and executed, orthodontic interventions can harmonize tooth positions within the alveolar housing and mitigate periodontal strain, reducing the risk of gingival margin breakdown.
Conversely, poorly controlled tooth movements—particularly labial proclination or expansion beyond the alveolar boundaries—may elevate the risk of recession in susceptible individuals, underscoring the importance of precise diagnosis, biomechanical strategy, and interdisciplinary collaboration.
Patients with thin periodontal biotypes present unique clinical challenges.
A comprehensive pre-treatment assessment—including clinical periodontal phenotype evaluation and advanced imaging such as cone-beam computed tomography—enables clinicians to identify sites at elevated risk of gingival recession and tailor orthodontic mechanics accordingly.
In these cases, controlled force application, careful space creation, and judicious torque modulation help preserve periodontal integrity while achieving desired orthodontic outcomes.
Moreover, orthodontic therapy can be strategically integrated with periodontal procedures, such as soft tissue augmentation and root coverage techniques, to enhance gingival support and stability.
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Combining orthodontic and periodontal planning not only addresses pre-existing recession defects but also prevents progression by optimizing tooth positions relative to the supporting tissues.
This integrated paradigm reflects a shift toward evidence-informed, patient-centered care that balances esthetic outcomes with long-term periodontal health.
As adult orthodontics continues to expand in clinical practice, understanding the complex interplay between tooth movement and periodontal tissue response is essential.
Clinicians must weigh biomechanical ambitions against biological limits, ensuring that interventions safeguard periodontal health and deliver sustainable, aesthetically pleasing results.
📄 Read the full article and download the PDF here: The role of orthodontics in the prevention and management of gingival recession — Nature / British Dental Journal (2024)
