Post-orthodontic lower incisor inclination and gingival recession—a systematic review

Background: The present systematic review was carried out to determine the correlation between gingival recession/bone height and incisor inclination in non-growing post-orthodontic patients compared to adult untreated subjects or patients treated with different methodologies.Materials and methods: PubMed, EMBASE, Web of Science, Scopus, Cochrane, and OpenGrey databases were searched without time and language restriction. Search terms included orthodontic, incisor, inclination, angulation, proclination, and gingival. Articles involving human participants and adult subjects receiving orthodontic treatment with fixed appliance, having incisors position, bone height and/or gingival recessions evaluated pre- and post-treatment were included. Two authors independently extracted data using predefined forms. Risk of bias in individual studies was assessed with the Newcastle-Ottawa Scale.Results: Two observational studies were included in the qualitative analysis. The heterogeneity in outcome assessment among the studies did not allow performing a meta-analysis. The two studies, while observing some effects of orthodontic treatment on the development of gingival recession, reported that these effects were not statistically or clinically significant.Conclusions: There is no strong scientific evidence concluding that proclination of incisors by means of fixed orthodontic appliances can affect periodontal health. Further prospective studies are required to elucidate this statement.Protocol: PROSPERO database registration number CRD42016042369.