Orthodontic treatment, craniofacial morphology and periodontal phenotype: A narrative review

This narrative review synthesizes the available evidence that assesses the potential link between orthodontic treatment and gingival/periodontal health. It is believed that excessive mandibular incisor proclination associated with thin labial bone and gingival phenotype is a significant risk factor for developing gingival recession. This review will focus on available gingival phenotypes assessment methods and the portrayed association between craniofacial morphology and periodontal characteristics. The impact of these topics on orthodontic treatment is discussed. The various methods for determining gingival phenotypes tested in the literature demonstrate the benefits of direct measurements. Using ultrasound to identify gingival phenotype is a promising diagnostic tool for evaluating dental soft tissues. However, the practical limitations of direct methods have led to the continued use of indirect methods, which may not provide reliable results when used by themselves. Although studies have examined and confirmed a relationship between alveolar bone thickness and craniofacial morphology, this review has found limited knowledge of the association between craniofacial and gingival morphology. Nevertheless, as part of the treatment planning process before orthodontic or combined orthodontic-orthognathic treatment, it is always important to consider the individual's gingival phenotype.