Labial movement of mandibular incisors and gingival recession
Aziz T, Flores-Mir C. A systematic review of the association between appliance-induced labial movement of mandibular incisors and gingival recession. Aust Orthod J 2011;27:33-9
Proclination, or anterior movement, of the mandibular incisors is often achieved to correct anterior crowding, improve facial esthetics, or optimize the occlusion. It has been proposed that labial movement of the mandibular incisors can cause the gingival attachment to migrate apically. The purpose of this study was to review the literature in regard to the association of appliance-induced labial movements of the mandibular incisors and gingival recession. The authors searched electronic databases for studies with the following terms: “incisor,” “incisor proclination,” “tooth movement,” “orthodontic tooth movement,” “gingival recession,” and “orthodontic appliance.” The inclusion criteria included human clinical trials that focused on the labial movement of mandibular incisors and gingival recession resulting from orthodontic treatment. The exclusion criteria included periodontal disease, subjects taking medications, those with a systemic disease that could affect gingival health, and significant intrusion or extrusion of the mandibular incisors. Seven articles, from a total of 34 initially retrieved, met the selection criteria. The results indicated no consistent association between proclination or anterior movement of the mandibular incisors and gingival recession. The literature suggested that gingival recession after orthodontic treatment might be related to local factors including the quality of the gingival tissue and biotype, the thickness of the alveolar bone, inadequate plaque control, and aggressive brushing.
Reviewed by Mark Causey
Changes in pharyngeal airway and respiratory function during sleep after mandibular setback
Hasebe D, Kobayashi T, Hasegawa M, Iwamoto T, Kato K, Izumi N, et al. Changes in oropharyngeal airway and respiratory function during sleep after orthognathic surgery in patients with mandibular prognathism. Int J Oral Maxillofac Surg 2011;40:584-92
Mandibular prognathism is a diagnostic finding in many skeletal Class III patients. Mandibular setback via bilateral sagittal split osteotomy might be the surgical procedure of choice in these patients. The purpose of this study was to determine the changes in oropharyngeal airway and respiratory function during sleep after mandibular setback. This study involved 22 subjects who had mandibular setback alone or in conjunction with a LeFort I osteotomy. All 22 subjects had no symptoms of obstructive sleep apnea before surgery. The control group consisted of 10 subjects without reported symptoms of obstructive sleep apnea and did not require orthognathic surgery. Polysomnographic examination was performed on the subjects before and 6 months after surgery. The control group also underwent the same testing. No subject in either group was diagnosed with obstructive sleep apnea at the initial examination. During the second examination, no control subject and 2 subjects who had mandibular setback were diagnosed as having mild obstructive sleep apnea. No subject reported any subjective symptoms of obstructive sleep apnea. In both surgical subjects who were diagnosed with the mild form of obstructive sleep apnea, the amounts of mandibular setback were significant (13.7 and 12.6 mm at pogonion). The latter patient also underwent maxillary advancement via a LeFort I osteotomy. Despite the small sample size, the authors concluded that the possibility of sleep-disordered breathing can increase as the length of the mandibular setback increases. Therefore, they recommended that, in patients with large anteroposterior skeletal discrepancy and mandibular prognathism, it might be wise to consider maxillary advancement alone or in conjunction with a smaller mandibular setback.
Reviewed by Travis Fiegle
Changes in pharyngeal airway and respiratory function during sleep after mandibular setback
Hasebe D, Kobayashi T, Hasegawa M, Iwamoto T, Kato K, Izumi N, et al. Changes in oropharyngeal airway and respiratory function during sleep after orthognathic surgery in patients with mandibular prognathism. Int J Oral Maxillofac Surg 2011;40:584-92
Mandibular prognathism is a diagnostic finding in many skeletal Class III patients. Mandibular setback via bilateral sagittal split osteotomy might be the surgical procedure of choice in these patients. The purpose of this study was to determine the changes in oropharyngeal airway and respiratory function during sleep after mandibular setback. This study involved 22 subjects who had mandibular setback alone or in conjunction with a LeFort I osteotomy. All 22 subjects had no symptoms of obstructive sleep apnea before surgery. The control group consisted of 10 subjects without reported symptoms of obstructive sleep apnea and did not require orthognathic surgery. Polysomnographic examination was performed on the subjects before and 6 months after surgery. The control group also underwent the same testing. No subject in either group was diagnosed with obstructive sleep apnea at the initial examination. During the second examination, no control subject and 2 subjects who had mandibular setback were diagnosed as having mild obstructive sleep apnea. No subject reported any subjective symptoms of obstructive sleep apnea. In both surgical subjects who were diagnosed with the mild form of obstructive sleep apnea, the amounts of mandibular setback were significant (13.7 and 12.6 mm at pogonion). The latter patient also underwent maxillary advancement via a LeFort I osteotomy. Despite the small sample size, the authors concluded that the possibility of sleep-disordered breathing can increase as the length of the mandibular setback increases. Therefore, they recommended that, in patients with large anteroposterior skeletal discrepancy and mandibular prognathism, it might be wise to consider maxillary advancement alone or in conjunction with a smaller mandibular setback.
Reviewed by Travis Fiegle
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