The incidence of gingival recession with non-surgical crossbite correction using completely customized lingual appliances versus surgically assisted rapid palatal expansion in adults: a cohort study.

Background: The aim of this study was to investigate if there is a significant difference in the incidence of buccal gingival recession after non-surgical transversal dentoalveolar compensation with completely customized lingual appliances (DC-CCLA) versus surgically assisted rapid palatal expansion (SARPE).

Methods: This cohort study included 81 adult patients with posterior crossbite. The DC-CCLA group (n = 38; f/m 25/13; mean age 30.3 ± 13.0 years) was treated with dentoalveolar compensation using completely customized lingual appliances. The SARPE-group (n = 43; f/m 19/24; mean age 28.2 ± 9.4 years) was treated with SARPE and buccal straight wire appliances. The number of buccal gingival recessions was recorded on digital models before treatment (T0) and after removal of fixed appliances (T1). Statistical analyses included Fisher's exact tests, Chi-squared tests, Mann-Whitney U tests and mixed-effects logistic regression to evaluate the influence of various variables on the incidence of gingival recession.

Results: In 3976 teeth evaluated, the incidence of developing gingival recessions was 8.1% with DC-CCLA (n = 77) and 5.8% with SARPE (n = 60). This difference was not statistically significant (p > 0.05). Age was a significant factor for the incidence of gingival recession and recessions were more likely to occur in males and in the maxillary posterior region.

Conclusions: There was no statistically significant difference in the incidence of gingival recessions between dentoalveolar compensation with CCLAs and SARPE after debonding, with some degree of gingival recession being inevitable with both treatment approaches.