Sammanfattning
An increasing number of young patients with advanced gingival recessions in the lower front
area have recently been referred for clinical examination and treatment. The majority of these
patients have a history of past orthodontic treatment with fixed appliance. These buccal recessions in
the lower front may cause cosmetic concern. The challenge is, however, that the loss of attachment is
approaching the apex of the tooth.
The literature has discussed whether fixed orthodontic therapy itself, or together with other factors,
may cause gingival recession. Studies have shown conflicting results and currently no clear
conclusions can be drawn. Definitely, the orthodontic treatment has to be carefully planned in
patients with anatomical risk factors as narrow alveolar ridge, thin gingival biotype and buccal
alveolar bone defects. In addition, light forces have to be applied allowing the alveolar bone to be
remodeled. During treatment, the patients have to be instructed in daily oral hygiene to maintain
gingival health. To prevent the occurrence of gingival recessions after treatment, the teeth have to be
positioned in the alveolar bone and with a properly constructed and bonded lingual retainer.
If gingival recession has to be treated, stable long term results can be obtained with orthodontic
treatment, mucogingival surgery, or a combination of these. The objective of this article is to discuss
important etiological factors and treatment alternatives, exemplified with two clinical cases.