Periodontal changes in patients with skeletal Class III malocclusion with and without prophylactic gingival grafting during presurgical orthodontic treatment.

INTRODUCTION

This study aimed to evaluate periodontal tissue changes after prophylactic gingival grafting in patients with skeletal Class III malocclusion undergoing presurgical orthodontic treatment involving mandibular incisor proclination.

METHODS

A total of 28 patients with skeletal Class III malocclusion scheduled for orthognathic surgery were included. Thirteen received subepithelial connective tissue grafts before orthodontic treatment (graft group), whereas 15 did not (nongraft group). Lateral cephalograms and cone-beam computed tomography images were taken before and after treatment to perform cephalometric and periodontal measurements. The primary outcomes were supracrestal gingival area (GA) and gingival thickness (GT) 1-5. Secondary outcomes included alveolar bone thickness (BT) 1-5, vertical bone height, and clinical crown length. Statistical analyses included intragroup changes, intergroup comparisons, and regression analyses.

RESULTS

In the graft group, GA and GT significantly increased. In contrast, BT2 and BT3 decreased, and vertical bone height increased, indicating vertical bone loss. No gingival recession was observed in either group. In exploratory analyses, increases in GA, GT1, and GT2 were negatively associated with a change in the incisor mandibular plane angle, whereas increases in GT3-5 were negatively associated with age.

CONCLUSIONS

Prophylactic gingival grafting before presurgical orthodontic treatment increased GT and GA in patients with skeletal Class III malocclusion, even in the presence of alveolar bone loss.