Periodontal consequences of mandibular incisor proclination during presurgical orthodontic treatment in Class III malocclusion patients

Angle Orthod. 2015 May;85(3):427-33. doi: 10.2319/021414-110.1. Epub 2014 Aug 4.

Abstract

Objective: To test the hypothesis that periodontal changes are similar between proclined and minimal-changed mandibular incisor position groups during presurgical orthodontic treatment for Class III orthognathic surgery.

Materials and methods: The following measurements were performed before and after presurgical orthodontic treatment of 75 patients (proclination group, 39 subjects; minimal-change group, 36 subjects): clinical crown length, sulcus and bone probing depths, and width of attached gingiva from clinical examination; infradentale-to-MP (perpendicular distance of infradentale to mandibular plane) from examination of lateral cephalograms; and the distance between the cementoenamel junction and alveolar crest from examination of periapical radiographs. Data were compared between the two groups, and a regression analysis was performed to investigate factors affecting the periodontal changes.

Results: In both groups, clinical crown length and bone probing depth increased during presurgical orthodontics (P < .05). Infradentale-to-MP and the width of attached gingiva decreased more in the proclination group than in the minimal-change group (P < .05). Proclination and protrusion of the mandibular incisors, and treatment duration affected the periodontal changes.

Conclusions: The null hypothesis was rejected. Proclination of the mandibular incisors for decompensation in Class III surgery patients seems to result in labial alveolar bone recession and a decrease in width of attached gingiva. However, the amount of the periodontal recession appeared to be clinically insignificant.

Keywords: Class III malocclusion; Mandibular incisor proclination; Orthodontic treatment; Periodontal tissue change.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Alveolar Bone Loss / etiology
  • Alveolar Process / diagnostic imaging
  • Alveolar Process / pathology
  • Cephalometry / methods
  • Female
  • Follow-Up Studies
  • Gingival Recession / etiology
  • Humans
  • Incisor / pathology*
  • Male
  • Malocclusion, Angle Class III / surgery
  • Malocclusion, Angle Class III / therapy*
  • Mandible / pathology*
  • Orthognathic Surgical Procedures / methods
  • Periodontium / pathology*
  • Preoperative Care
  • Radiography, Bitewing
  • Retrospective Studies
  • Tooth Cervix / pathology
  • Tooth Crown / pathology
  • Young Adult