Clinical Crown Length Changes and Gingival Recessioa Development in Anterior Teeth Associated with Orthodontic Treatment: A Systematic Review and Meta-Analysis

Abstract

AIM: To systematically investigate and appraise the quality of the available evidence regarding clinical crown length changes and gingival recession development following orthodontic treatment.

MATERIALS AND METHOD: A search without restrictions for published and unpublished literature and hand searching was performed. Data on incisor clinical crown length changes and gingival recession development following orthodontic treatment were reviewed. Measurements before and after orthodontic treatment, as well as case-control studies, were considered. Relevant information was extracted, methodological quality was evaluated using the ROBINS-I tool (Risk Of Bias In Nonrandomized Studies of Interventions) and the random effects model was used to combine the retrieved data.

RESULTS: Ten studies following patients for up to 6 years after orthodontic treatment were finally identified. Clinical crown length increased after orthodontic treatment and during retention. However, in general, no differences were noted iii between the groups that underwent proclination compared to the non-proclination group. Moreover, orthodontic treatment seemed to increase the odds for a patient to exhibit gingival recession in at least one tooth, compared to before treatment. In addition, orthodontic treatment seemed to increase the odds for a patient to exhibit gingival recession in at least one mandibular incisor, compared to before treatment or the untreated controls.

CONCLUSIONS: The present systematic review and meta-analysis showed that some increases in gingival recession prevalence may be encountered after orthodontic treatment. Although clinical crown length increases during orthodontic treatment and retention, overall no statistically significant differences were noted between incisors having undergone proclination compared to the non-proclination group. More high quality studies are needed in order to further elucidate possible associations.