Periodontal status of mandibular incisors after pronounced orthodontic advancement during adolescence: A follow-up evaluation

The purpose of this study was to analyze whether pronounced orthodontic adv ancement of the mandibular incisors during Class II correction in the mixed dentition results in gingival recession,Through mandibular superimposition of the pretreatment and posttreatment cephalograms of 67 Class II patients who were treated with reverse headgear to the mandibular dentition, 45 pat ients with a minimum of a 1-mm advancement of the cementoenamel junction (C EJ; mean, 2.18 +/- 0.87) and a minimum of a 2-mm advancement of the incisal edge (mean, 3.87 +/- 1.34) were identified, Using the same protocol in Cla ss II patients, 30 individuals who finished treatment at a similar time and age, but without reverse headgear and with no advancement of the CEJ (mean -0.43, SD 0.53) and a maximum of 1-mm advancement of the incisal edge (mea n -0.26 SD 1.15) were identified. Before treatment, the mandibular incisors were more retruded, relative to the line from point A to pogonion and rela tive to the mandibular plane in the patients with pronounced advancement th an in those with no advancement of the mandibular incisors; no differences were found at the time of appliance removal. A total of 30 patients with pr onounced advancement and 21 patients with no advancement could meet for a f ollow-up examination a mean period of 7.83 years (SD, 4.44) and 9.38 years (SD, 4.39) after treatment, respectively. Clinical examinations at the time of follow-up revealed no differences in the amount of recession, the width of attached gingiva, the length of supracrestal connective tissue attachme nt, the probing pocket depth, and gingival bleeding index or visible plaque index of the mandibular incisors between the patients in the 2 groups. An examination of color slides demonstrated no differences in the number of ma ndibular incisors that developed recession from before treatment to after t reatment and from after treatment to follow-up, Measurement of mandibular i ncisor crown height on the study models demonstrated no difference in the i ncrease in clinical crown height from after treatment to follow-up between the patients in the 2 groups. It was concluded that pronounced advancement of the mandibular incisors may be performed in adolescent patients with den toalveolar retrusion without increasing the risk of recession.