Kloukos Dimitrios, Koukos George, Pandis Nikolaos, Doulis Ioannis, Stavropoulos Andreas, Katsaros Christos
Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010 Bern, Switzerland.
Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force Hospital, Panagioti Kanellopoulou 3, 11525, Athens, Greece.
Eur J Orthod. 2025 Apr 8;47(3). doi: 10.1093/ejo/cjaf022.
To assess in a prospective controlled study whether orthodontic treatment with fixed appliances results in development of gingival recession (GR), compared with an untreated group of participants.
MATERIALS & METHODS: The sample consisted of 40 consecutive adult orthodontic patients (Intervention group) and 40 untreated adult volunteers, that satisfied the inclusion and exclusion criteria and were selected from the same background population, as the control group. GR was measured as part of a full periodontal assessment: before treatment (T0) and 12 months after removal of the fixed appliances (T1) in the intervention group, i.e. at about 30 months from T0, and at baseline (T0) and 30 months after (T1) in the control group. A count data model was fit using the sum of recessions at T1 and as predictors: treatment, periodontal phenotype (thin/thick), side (buccal/lingual), sex, age, and number of recessions at baseline, with robust standard errors to account for the multiple within patient observations.
Nineteen females and 21 males in each group [mean age in years (range): intervention group 23.1 (16.8 - 43.3); control: 21.85 (18.2 - 43.9)] were analyzed. During the whole study period, the control group exhibited a modest increase in the number of recessions over time. Several patients in the intervention group exhibited a larger increase in the number of recessions than the controls. However, this was partly counteracted by a considerable amount of reduction in the number of recessions in several patients receiving treatment. The adjusted incidence for recession was 67% higher for the intervention group versus the control group (IRR = 1.67, 95% CIs: 1.05, 2.67, P = 0.03). Most recessions, though, were up to 1mm. The most affected teeth were the canines and the first premolars.
Compared to untreated individuals, patients undergoing orthodontic treatment with fixed appliances showed a higher incidence rate of gingival recession at 1-year posttreatment, adjusted for age, periodontal phenotype, side, gender and number of recessions at baseline. However, the severity of gingival recessions was of limited extent.
在一项前瞻性对照研究中，评估与未接受治疗的参与者组相比，使用固定矫治器进行正畸治疗是否会导致牙龈退缩（GR）的发生。
样本包括40名连续的成年正畸患者（干预组）和40名未接受治疗的成年志愿者，他们满足纳入和排除标准，且选自相同的背景人群作为对照组。GR作为全面牙周评估的一部分进行测量：在干预组中，治疗前（T0）以及去除固定矫治器后12个月（T1），即距T0约30个月时测量；在对照组中，在基线（T0）和30个月后（T1）测量。使用T1时退缩总和作为预测变量拟合计数数据模型：治疗、牙周表型（薄/厚）、牙面（颊侧/舌侧）、性别、年龄以及基线时的退缩数量，并采用稳健标准误以考虑患者内部的多个观察值。
每组分析了19名女性和21名男性[年龄均值（范围）：干预组23.1（16.8 - 43.3）岁；对照组21.85（18.2 - 43.9）岁]。在整个研究期间，对照组的退缩数量随时间略有增加。干预组的几名患者退缩数量的增加幅度大于对照组。然而，接受治疗的几名患者退缩数量的大量减少部分抵消了这一情况。干预组退缩的调整发病率比对照组高67%（发病率比=1.67，95%置信区间：1.05，2.67，P = 0.03）。不过，大多数退缩不超过1毫米。受影响最严重的牙齿是尖牙和第一前磨牙。
与未接受治疗的个体相比，在根据年龄、牙周表型、牙面、性别以及基线时的退缩数量进行调整后，接受固定矫治器正畸治疗的患者在治疗后1年牙龈退缩的发病率更高。然而，牙龈退缩的严重程度有限。
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