{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:34:34Z","timestamp":1793140474015,"version":"4.5.0"},"reference-count":75,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T00:00:00Z","timestamp":1689033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,18]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background\/objectives<\/jats:title>\n                  <jats:p>To systematically review the available evidence concerning the risk factors for gingival recessions (GR) after orthodontic treatment (OT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data collection and analysis<\/jats:title>\n                  <jats:p>Data was obtained and collected by systematically searching 3 data bases: Pubmed, EMBASE, and Web of Science until 20 April 2023. Controlled trials, cohort, case-control or cross-sectional studies describing GR or clinical crown height (CCH) after OT were included. The risk of bias in the selected studies was evaluated with the methodological index for non-randomized studies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty-eight articles were included, investigating the following six risk factors for GR: 1. OT (n = 21), 2. Type of orthodontic intervention (n = 32), 3. Patient\u2019s baseline occlusal and skeletal characteristics (n = 14), 4. Mucogingival characteristics (n = 10), 5. Oral hygiene (n = 9), and 6. Others (n = 12). Significantly higher prevalence, severity and extent of GR were found in orthodontic patients by 10\/15, 4\/10, and 2\/2 articles respectively. 10\/16 articles reported significantly more GR and increased CCH in patients where orthodontic incisor proclination was performed. The evidence surrounding maxillary expansion and orthodontic retention was too heterogeneous to allow for? definitive conclusions. Pre-treatment angle classification, ANB, overjet, overbite, arch width and mandibular divergence were found not to be associated with GR (9\/14), while pre-treatment crossbite, symphysis height and width were (5\/7 studies). A thin gingival biotype, presence of previous GR, baseline width of keratinized gingiva and facial gingival margin thickness were correlated with increased risk of GR after OT by nine articles, while pocket depth was not. Oral hygiene, sex, treatment duration, and oral piercings were found not to be linked with GR in orthodontic patients, while GR was reported to increase with age in orthodontic patients by 50 per cent of the articles investigating this factor. The mean risk of bias for comparative and not comparative studies was 14.17\/24 and 9.12\/16.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Limitations<\/jats:title>\n                  <jats:p>The selected studies were quite heterogeneous regarding study settings, variables reported and included very limited sample sizes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Although studies regarding the risk factors for GR are relatively abundant, they are very heterogeneous concerning design, studied factors, methodology and reporting, which often leads to contradictory results. Uniform reporting guidelines are urgently needed for future research.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO Registration<\/jats:title>\n                  <jats:p>CRD42020181661.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Funding<\/jats:title>\n                  <jats:p>This research received no funding.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejo\/cjad026","type":"journal-article","created":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:53:47Z","timestamp":1684976027000},"page":"528-544","source":"Crossref","is-referenced-by-count":37,"title":["Risk factors for gingival recessions after orthodontic treatment: a systematic review"],"prefix":"10.1093","volume":"45","author":[{"given":"Maria","family":"Cadenas de Llano-P\u00e9rula","sequence":"first","affiliation":[{"name":"Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven , Belgium"},{"name":"Research group Orthodontics, KU Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Bel\u00e9n","family":"Castro","sequence":"additional","affiliation":[{"name":"Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven , Belgium"},{"name":"Research group Periodontology and Oral Microbiology, KU Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaux","family":"Danneels","sequence":"additional","affiliation":[{"name":"Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven , Belgium"},{"name":"Research group Orthodontics, KU Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alix","family":"Schelfhout","sequence":"additional","affiliation":[{"name":"Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"Teughels","sequence":"additional","affiliation":[{"name":"Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven , Belgium"},{"name":"Research group Periodontology and Oral Microbiology, KU Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Willems","sequence":"additional","affiliation":[{"name":"Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven , Belgium"},{"name":"Research group Orthodontics, KU Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,11]]},"reference":[{"key":"2023091805150219500_CIT0001","first-page":"S204","article-title":"Mucogingival conditions in the natural dentition: narrative review, case definitions, and \u00addiagnostic considerations","volume":"89","author":"Cortellini","year":"2018","journal-title":"Journal of Periodontology"},{"key":"2023091805150219500_CIT0002","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/S0300-5712(01)00035-5","article-title":"Gingival recession-its significance and management","volume":"29","author":"Tugnait","year":"2001","journal-title":"Journal of Dentistry"},{"key":"2023091805150219500_CIT0003","doi-asserted-by":"crossref","first-page":"220","DOI":"10.14219\/jada.archive.2003.0137","article-title":"The etiology and prevalence of gingival recession","volume":"134","author":"Kassab","year":"2003","journal-title":"Journal of the American Dental Association"},{"key":"2023091805150219500_CIT0004","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1111\/j.1600-051X.2007.01149.x","article-title":"Does tooth brushing influence the development and progression of non-inflammatory gingival recession? 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