Dias Alexandra Tavares, Lopes Jessica Figueiredo, Fernandes Juliana Campos Hasse, Fernandes Gustavo Vicentis Oliveira
Periodontics Department, State University of Rio de Janeiro (UERJ), Rio de Janeiro 20550-013, RJ, Brazil.
Independent Researcher, St. Louis, MO 63104, USA.
Dent J (Basel). 2025 Feb 21;13(3):93. doi: 10.3390/dj13030093.
: The prevalence of gingival recessions (GRs) in the global population is 78%. A long-term study showed a 47% increase in the prevalence of GRs five years post-orthodontic treatment, particularly in the lower anterior region. It can be caused and/or exacerbated after orthodontic treatment, where the retainer placed can induce tooth movement or when it fails to maintain a passive position upon bonding. Thus, the goal of this case report was to present treatments for gingival recessions, with the approaches of the laterally closed tunnel technique and parallel incision methods, after orthodontic treatment in patients using non-passive lingual retainers. : This case report adhered to the CARE guidelines. Three healthy patients were referred due to GR defects in the lower anterior region (RT1 and RT2). All patients had GR associated with deficient lingual-fixed orthodontics retainers. The same experienced periodontist (ATD) developed the surgeries and aimed to achieve root coverage using the connective tissue graft associated with a coronally advanced flap (CAF) and modify the recipient area's gingival phenotype. : In all cases, a new orthodontic treatment was not possible due to anatomical or patient-related factors. Outcomes after six months, three years, and five years are presented, encompassing clinical and esthetic evaluations. : GRs must always be addressed by orthodontic therapy or lingual-fixed orthodontic retainers. In cases where dental elements are positioned outside the bone envelope, orthodontic treatment may be considered before root coverage surgery. Therefore, surgical intervention should be undertaken for the keratinized tissue and volume gain, independently of the tooth position. Modifying the phenotype in these situations is vital for the long-term maintenance of periodontal health.
全球人群中牙龈退缩（GRs）的患病率为78%。一项长期研究表明，正畸治疗五年后GRs的患病率增加了47%，尤其是在下前牙区域。正畸治疗后可能会引发和/或加剧这种情况，比如佩戴的保持器可能会导致牙齿移动，或者在粘结时未能保持被动位置。因此，本病例报告的目的是介绍在使用非被动舌侧保持器的患者正畸治疗后，采用侧向闭合隧道技术和平行切口方法治疗牙龈退缩的情况。
本病例报告遵循了CARE指南。三名健康患者因下前牙区域的GR缺陷（RT1和RT2）前来就诊。所有患者的GR均与舌侧固定正畸保持器不足有关。同一位经验丰富的牙周病医生（ATD）开展了手术，旨在通过与冠向推进瓣（CAF）相关的结缔组织移植实现牙根覆盖，并改变受区的牙龈表型。
在所有病例中，由于解剖学或患者相关因素，无法进行新的正畸治疗。报告呈现了六个月、三年和五年后的结果，包括临床和美学评估。
GRs必须始终通过正畸治疗或舌侧固定正畸保持器来解决。在牙齿位于骨膜外的情况下，在进行牙根覆盖手术前可考虑正畸治疗。因此，无论牙齿位置如何，都应进行手术干预以增加角化组织和体积。在这些情况下改变表型对于牙周健康的长期维持至关重要。
