Clear Aligners - An efficient tool in the combined Ortho-Perio treatment of gingival recessions

Abstract

Gingival recession of lower incisors is a periodontal condition that mostly develops in young adults as a result of various etiological factors, such as mechanical trauma, bacterial associated gingival inflammation, viral infection or a mixture of the above. Several predisposing factors contribute to its occurrence, including thin gingival biotype, reduced alveolar bone thickness, the presence of dehiscence and fenestrations, frenum pull, root malposition due to crowding or previous orthodontic treatment, as well as distorted fixed orthodontic retainers. The treatment approaches vary from supportive periodontal therapy alone to different surgical root coverage procedures. In situations where the root is in close proximity to or beyond the cortical bone, orthodontic repositioning of the root within the bone prior to surgical root coverage has been shown to be beneficial. Historically, such orthodontic correction required insertion of fixed orthodontic devices over an extended period, which posed challenges to patients who may have already undergone orthodontic treatment in the past and are therefore reluctant to undergo retreatment. This case series illustrates that, in contrast to certain beliefs, clear aligners are an effective tool for repositioning the lower incisors’ roots before surgical root coverage procedures. The article provides guidelines for treatment planning and aligners’ design to achieve the best outcome in the shortest duration.