American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics · 2013
Association between gingival recession and proclination of maxillary central incisors near the cleft in patients with unilateral cleft lip and palate: A retrospective case-control study.
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Zhu Shiwen, Chen Zhenqi
Аннотация
INTRODUCTION: The aim of this study was to investigate whether proclination of the maxillary central incisor near a cleft leads to gingival recession in patients born with unilateral cleft lip and palate.
METHODS: Forty patients with unilateral cleft lip and palate were retrospectively enrolled. By using intraoral slides, casts, and cephalograms, changes in gingival recession and proclination were measured. The 2-sample t test, correlation, and stepwise logistic regression analyses were applied.
RESULTS: There were statistically significant differences in proclination variations between subjects with and without increased gingival recession (P <0.0001). A positive correlation was shown between proclination and gingival recession. Bone grafting during treatment resulted in a significant difference in gingival recession (P <0.05). Every 2° of increase in the angle between the long axis of the maxillary central incisors and the sella-nasion plane had a 3.06 times greater risk for gingival recession (odds ratio, 3.06; 95% confidence interval, 1.329-7.046; P = 0.0086).
CONCLUSIONS: Proclination of the maxillary central incisor adjacent to the cleft is positively correlated with gingival recession in patients with unilateral cleft lip and palate. Proclination should be limited to prevent gingival recession and its esthetic and functional problems. It is better for a borderline cleft patient to have orthognathic surgery rather than camouflage treatment. Bone grafting during treatment might benefit gingival recession. The angle between the long axis of the maxillary central incisors and the sella-nasion plane is considered the strongest predictor of gingival recession.
METHODS: Forty patients with unilateral cleft lip and palate were retrospectively enrolled. By using intraoral slides, casts, and cephalograms, changes in gingival recession and proclination were measured. The 2-sample t test, correlation, and stepwise logistic regression analyses were applied.
RESULTS: There were statistically significant differences in proclination variations between subjects with and without increased gingival recession (P <0.0001). A positive correlation was shown between proclination and gingival recession. Bone grafting during treatment resulted in a significant difference in gingival recession (P <0.05). Every 2° of increase in the angle between the long axis of the maxillary central incisors and the sella-nasion plane had a 3.06 times greater risk for gingival recession (odds ratio, 3.06; 95% confidence interval, 1.329-7.046; P = 0.0086).
CONCLUSIONS: Proclination of the maxillary central incisor adjacent to the cleft is positively correlated with gingival recession in patients with unilateral cleft lip and palate. Proclination should be limited to prevent gingival recession and its esthetic and functional problems. It is better for a borderline cleft patient to have orthognathic surgery rather than camouflage treatment. Bone grafting during treatment might benefit gingival recession. The angle between the long axis of the maxillary central incisors and the sella-nasion plane is considered the strongest predictor of gingival recession.