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Informationen aus Orthodontie & Kieferorthopädie 2015; 47(02): 86-92
DOI: 10.1055/s-0035-1549950
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© Georg Thieme Verlag KG Stuttgart · New York

Kieferorthopädie und gingivale Rezessionen

Orthodontics and Gingival Recessions
K. Bertl
1   Abteilung für Parodontologie, Universität Malmö, Schweden
2   Fachbereich für Orale Chirurgie, Universitätszahnklinik Wien, Österreich
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Publication History

Publication Date:
03 July 2015 (online)

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Zusammenfassung

Zielsetzung: Anhand folgender 3 Fragestellungen wird ein Überblick zu der Thematik “Kieferorthopädie und gingivale Rezessionen” gegeben:(1) Stellt eine kieferorthopädische Behandlung einen Risikofaktor für gingivale Rezessionen dar? (2) Kann gingivalen Rezessionen durch eine „prophylaktische“ Weichgewebsaugmentation vor kieferorthopädischer Therapie vorgebeugt werden? (3) Soll die Deckung einer bereits bestehenden gingivalen Rezession vor oder nach der kieferorthopädischen Behandlung erfolgen?

Ergebnis: Eine kieferorthopädische Behandlung als Risikofaktor für gingivale Rezessionen wird nach wie vor kontrovers diskutiert. Jedoch wiesen rezente Studien einen signifikanten Anstieg sowie eine gegenüber der Kontrollgruppe erhöhte Prävalenz an gingivalen Rezessionen in der Retentionsphase nach kieferorthopädischer Behandlung auf. Aber weder die Frage nach der Notwendigkeit einer „prophylaktischen“ Weichgewebsaugmentation vor einer kieferorthopädischen Behandlung noch die Frage nach dem optimalen Zeitpunkt zur Deckung einer bereits bestehenden gingivalen Rezession ist anhand der Literatur eindeutig zu beantworten.

Schlussfolgerung: Trotz noch kontroverser Diskussion scheint eine kieferorthopädische Behandlung als einer von mehreren Faktoren bei der Entstehung gingivaler Rezessionen eine Rolle zu spielen. Dementsprechend sollten andere Risikofaktoren mit berücksichtigt und eine Zahnbewegung aus dem Alveolarfach hinaus möglichst vermieden werden. Die Entscheidung, ob und wann eine kombinierte parodontologisch-kieferorthopädische Behandlung erfolgen sollte, ist nach wie vor subjektiv und nicht evidenz-basiert zu treffen.

Abstract

Objective: Based on the following 3 questions an overview is given on the topic “orthodontic treatment and gingival tissue recessions”:(1) Should orthodontic treatment be considered as risk factor for developing gingival tissue recessions? (2) Is a “prophylactic” soft tissue augmentation before orthodontic treatment justified to prevent gingival tissue recessions? (3) Should a root coverage procedure of a gingival tissue recession be performed before or after orthodontic treatment?

Results: Orthodontic treatment as a risk factor for gingival tissue recessions is still controversially discussed. Yet, recent studies presented a significant increase as well as compared to a control group a significantly higher prevalence of gingival tissue recessions in the retention phase after orthodontic treatment. Neither the question on the necessity of a “prophylactic” soft tissue augmentation before orthodontic treatment, nor the question on the best time point of root coverage procedures of an already existing gingival tissue recession can be answered by the available literature.

Conclusion: Although this topic is still controversially discussed, orthodontic treatment seems to be an influencing factor in the multifactorial process of gingival tissue recession development. Hence, other known risk factors should be considered and tooth movement out of the alveolar socket should be avoided as far as possible. The decision on any combined periodontal-orthodontic treatment is still made on a subjective and not evidence-based level.

Schlüsselwörter

Kieferorthopädie - gingivale Rezession - Rezessionsdeckung - Weichgewebsaugmentation

Key words

orthodontic treatment - gingival tissue recession - root coverage procedure - soft tissue augmentation
 

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