Orthodontic treatment in the presence of recessions

Causes of recessions

• The wrong position of the tooth when it is tilted so that the root comes out slightly.
• Aggressive brushing of teeth with a hard brush. With daily exposure, soft tissues are injured, and they gradually decrease.
• Anatomical feature: thin alveolar process. Even a small movement of teeth or improper brushing can worsen recessions.
• Short bridles and mucous cords that stretch the soft tissues during articulation and provoke gum loss.
• Dental deposits. A large volume of hard plaque (tartar) accumulates under the gum and gradually pushes it lower.
• Unclear (idiopathic) causes.
• Endocrine pathologies.

Can treatment be started in the presence of recession?

If a patient already has visual gingival recession, the orthodontist will refer the patient to a periodontist for a consultation before treatment begins. The periodontist evaluates the amount and extent of recession, makes a prognosis, and decides whether the recession needs to be closed now or whether treatment can begin.

To improve periodontal health and reduce recession, a periodontist may recommend several remedies depending on the degree of pathology:

• Professional oral hygiene to remove tartar;
• Changing home hygiene techniques and products;
• Plasty of the frenulum or mucosal pulls that may be pulling on the gum;
• Recession closure surgery — closure of recessions with a flap from the palate.

After implementation of the recommendations or surgery, the periodontist evaluates the healing of the recession at a follow-up examination. If the gingival loss has been reduced, orthodontic treatment can begin.

The results of closing recessions before treatment on aligners

Can orthodontic treatment reduce recessions?

Sometimes orthodontic treatment can be started for small recessions and even reduce them if properly planned. If the tooth was tilted incorrectly, the change will cause the root to burrow into the bone and the recession will be reduced.

At the time of the change, the root will be buried in the bone and the recession will be reduced.

To reduce recession in braces treatment, the orthodontist plans for bends in the arch so that the tooth sinks a little lower into the gum and reduces the amount of root denudation. If the treatment is with eliners, the orthodontist plans the changes on a virtual set-up and orders customized mouthguards that make the desired tooth movements.

Reducing recessions after orthodontic treatment.

What should I do if recessions occur during or after treatment?

In complex treatment cases, we sometimes deliberately choose a treatment plan that has a risk of recessions when an alternative is either not possible or not suitable for the patient.

We always clearly explain the treatment plan, warn the patient of complications and refer them to a periodontist.

We always clearly explain the plan to the patient, warn them of complications, and refer them to a periodontist for a pre- or post-treatment consultation. If recessions do occur at the end of treatment, the patient will undergo surgery to close them.

In our practice, in most of these cases, we are able to create a correct bite and restore healthy gums without negative consequences.

Says

Dubovskaya Marina Anatolyevna

Today's orthodontic capabilities make it possible to address recessions in ways that were not possible in the past. The correct work of the therapist, orthopedist and surgeon can almost completely eliminate recessions and all the discomfort associated with them.