하악 전치부 치은퇴축의 치주수복을 위한 투명교정장치 기반의 교정치료

Clear Aligner-Based Orthodontic Approach for Periodontal Reconstruction of Mandibular Anterior Gingival Recession

Gingival recession is a common complication in orthodontic treatment, especially in patients with a thin gingival phenotype and alveolar bone. Excessive tooth movement beyond the alveolar housing can exacerbate this condition, particularly in non-extraction treatment plans involving arch expansion or proclination. When gingival recession occurs in the anterior region, it often results in esthetic concerns and reduced patient satisfaction. This case report describes an adult female patient presented with gingival recession of the mandibular central incisors following previous orthodontic treatment. Initial analysis revealed mild supraeruption and vertical alveolar bone loss, and CBCT confirmed the protrusion of the root apex beyond the labial cortical bone plate. A clear aligner-based orthodontic approach was applied to achieve root-centered movement, minimizing crown tipping and focusing on controlled root lingualization. After orthodontic repositioning, periodontal reconstruction was performed using a connective tissue graft combined with a coronally advanced flap. Post-treatment assessments demonstrated stable tooth alignment, successful root repositioning within the alveolar envelope, and significant improvement in the gingival contour. Digital scan superimpositions confirmed greater cervical than incisal movement, consistent with the treatment objectives. After the one-year follow-up, periodontal stability and favorable esthetic outcomes were maintained. This case highlights that clear aligner-based root movement can be an effective adjunctive strategy to enhance periodontal surgery outcomes and long-term stability in mandibular anterior gingival recession.