Do orthodontic patients develop more gingival recession in anterior teeth compared to untreated individuals? A systematic review of controlled studies

Abstract

Objective: To investigate, in an evidence-based manner, the contemporary available information regarding the development of gingival recession in the anterior teeth of orthodontically treated and age-matched untreated individuals.

Material and methods: Eight databases were searched without restrictions from the date of coverage initiation to June 30th, 2019 (registration in PROSPERO: CRD42018080948). Studies evaluating gingival recession development following comprehensive orthodontic treatment were reviewed. Following study selection, data extraction and risk of bias assessment, the random effects model was employed for exploratory data synthesis. The confidence in the retrieved estimates was appraised using current guidelines.

Results: Finally, three studies, with a follow-up of 6 years maximum, were identified. Overall, the amount of gingival recession did not increase significantly immediately after treatment with normal occlusion. However, for some of the comparisons considered, the risk for orthodontic patients to present with labial gingival recession seemed to increase, especially during retention [mandibular incisors 6 years post-treatment: Odds Ratio: 8.81, 95% Confidence Interval: 1.93–40.07, p = 0.005].

Conclusion: Although the amount of recession does not differ, some increase in the risk for gingival recession development in the anterior teeth may be encountered in orthodonticallytreated individuals compared to untreated subjects with normal occlusion. However, these findings should be viewed cautiously until more studies of high quality become available. Good practice would suggest that it is important to identify patients at potential risk and consider the possible implications for orthodontic treatment.