{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:37:11Z","timestamp":1792273031050,"version":"4.4.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This prospective controlled study aimed to assess whether changes in mandibular incisor inclination during orthodontic treatment with fixed appliances affect gingival thickness (GT) and the width of keratinized gingiva (WKG), and having as reference an untreated group of participants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>Forty consecutively recruited adult orthodontic patients and 40 untreated volunteers, matched for age and gender and selected from the same background population serving as controls, were included. Mandibular incisor inclination was measured in lateral cephalograms before treatment commencement (T0) and 1 month before fixed appliances\u2019 removal (T1). Gingival thickness was measured using an Ultrasound Device (US) and width of keratinized gingiva (WKG) using a standard periodontal probe within the frames of a full periodontal examination at T0, T1, and 1 year after bracket removal (T2), that is, at about 30 months from T1.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Nineteen females and 21 males in each group [mean age in years (range): intervention group 23.1 (16.8\u201343.3); control: 21.85 (18.2\u201343.9)] were analysed. Overall, change in incisor proclination [mean change in Incisor Mandibular Angle Plane\u2014IMPA (\u0394IMPA) was 6.35\u00b0 (SD 5.08\u00b0)] was not associated with any significant change in soft tissue thickness and with alterations in WKG. The group receiving fixed appliances did not exhibit thickening or thinning of GT in comparison to the control group; the WKG was reduced in the intervention group in comparison to the untreated group, where it essentially remained unchanged (#41: coeff.: \u22120.29, P value: .1, 95% CIs: \u22120.65, 0.06; #31: coeff.: \u22120.51, P value: .01, 95% CIs: \u22120.88, \u22120.14).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Lower incisor proclination during orthodontic treatment does not appear to significantly alter GT and WKG, but orthodontic treatment, overall, leads to reduction of the WKG.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejo\/cjaf001","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T12:18:04Z","timestamp":1736338684000},"source":"Crossref","is-referenced-by-count":7,"title":["Does incisor inclination change during orthodontic treatment affect gingival thickness and the width of keratinized gingiva? A prospective controlled study."],"prefix":"10.1093","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0665-238X","authenticated-orcid":false,"given":"Dimitrios","family":"Kloukos","sequence":"first","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern , Freiburgstrasse 7, CH-3010 Bern ,","place":["Switzerland"]},{"name":"Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force Hospital , Panagioti Kanellopoulou 3, 11525, Athens ,","place":["Greece"]},{"name":"Periodontology, Faculty of Odontology, Carl Gustafs v\u00e4g 34, 21421, Malm\u00f6 University ,\u00a0 Malm\u00f6 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Koukos","sequence":"additional","affiliation":[{"name":"Department of Periodontology, 251 Hellenic Air Force Hospital , Panagioti Kanellopoulou 3, 11525, Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Doulis","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force Hospital , Panagioti Kanellopoulou 3, 11525, Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Stavropoulos","sequence":"additional","affiliation":[{"name":"Periodontology, Faculty of Odontology, Carl Gustafs v\u00e4g 34, 21421, Malm\u00f6 University ,\u00a0 Malm\u00f6 ,","place":["Sweden"]},{"name":"Department of Periodontology, Blekinge Hospital , H\u00e4lsov\u00e4gen, Byggnad 13, 371 41, Karlskrona ,","place":["Sweden"]},{"name":"Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna , Sensengasse 2a, 1090, Vienna ,","place":["Austria"]},{"name":"Department of Periodontology, School of Dental Medicine, University of Bern , Freiburgstrasse 7, CH-3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Katsaros","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern , Freiburgstrasse 7, CH-3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,2,7]]},"reference":[{"key":"2025020710100274800_CIT0001","doi-asserted-by":"publisher","first-page":"S219","DOI":"10.1111\/jcpe.12951","article-title":"Periodontal manifestations of systemic diseases and developmental and acquired conditions: consensus report of workgroup 3 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions","volume":"45","author":"Jepsen","year":"2018","journal-title":"J Clin Periodontol"},{"key":"2025020710100274800_CIT0002","doi-asserted-by":"publisher","first-page":"S56","DOI":"10.1902\/jop.2015.130684","article-title":"Periodontal soft tissue non-root coverage procedures: a systematic review from the AAP regeneration workshop","volume":"86","author":"Kim","year":"2015","journal-title":"J Periodontol"},{"key":"2025020710100274800_CIT0003","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1111\/jcpe.12275","article-title":"Characteristics of periodontal biotype, its dimensions, associations and prevalence: a systematic review","volume":"41","author":"Zweers","year":"2014","journal-title":"J Clin Periodontol"},{"key":"2025020710100274800_CIT0004","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1902\/jop.2016.160284","article-title":"Periodontal conditions of sites treated with gingival augmentation surgery compared with untreated contralateral homologous sites: an 18- to 35-year long-term study","volume":"87","author":"Agudio","year":"2016","journal-title":"J Periodontol"},{"key":"2025020710100274800_CIT0005","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1902\/jop.2016.150625","article-title":"Long-term outcomes of untreated buccal gingival recessions: a systematic review and meta-analysis","volume":"87","author":"Chambrone","year":"2016","journal-title":"J Periodontol"},{"key":"2025020710100274800_CIT0006","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1043\/0003-3219(2002)072&lt;0238:CBMCIP&gt;2.0.CO;2","article-title":"Correlation between mandibular central incisor proclination and gingival recession during fixed appliance therapy","volume":"72","author":"Djeu","year":"2002","journal-title":"Angle Orthodontist"},{"key":"2025020710100274800_CIT0007","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1093\/ejo\/25.4.343","article-title":"Does labial movement of lower incisors influence the level of the gingival margin? A case-control study of adult orthodontic patients","volume":"25","author":"Allais","year":"2003","journal-title":"Eur J Orthod"},{"key":"2025020710100274800_CIT0008","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.ajodo.2006.01.015","article-title":"Periodontal status of mandibular central incisors after orthodontic proclination in adults","volume":"130","author":"Yared","year":"2006","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2025020710100274800_CIT0009","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1093\/ejo\/cjs045","article-title":"Gingival recessions and the change of inclination of mandibular incisors during orthodontic treatment","volume":"35","author":"Renkema","year":"2013","journal-title":"Eur J Orthod"},{"key":"2025020710100274800_CIT0010","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1007\/s00056-015-0308-2","article-title":"Does the decision to extract influence the development of gingival recessions? A retrospective long-term evaluation","volume":"76","author":"Villard","year":"2015","journal-title":"J Orofacial Orthopedics"},{"key":"2025020710100274800_CIT0011","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/s0889-5406(98)70244-6","article-title":"Does orthodontic proclination of lower incisors in children and adolescents cause gingival recession","volume":"114","author":"Ruf","year":"1998","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2025020710100274800_CIT0012","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.ajodo.2014.02.009","article-title":"Mandibular incisor inclination, tooth irregularity, and gingival recessions after Herbst therapy: a 32-year follow-up study","volume":"146","author":"Pancherz","year":"2014","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2025020710100274800_CIT0013","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1093\/ejo\/cju073","article-title":"Gingival labial recessions and the post-treatment proclination of mandibular incisors","volume":"37","author":"Renkema","year":"2015","journal-title":"Eur J Orthod"},{"key":"2025020710100274800_CIT0014","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1016\/j.ajodo.2016.09.027","article-title":"Prevalence of gingival recession after orthodontic tooth movements","volume":"151","author":"Morris","year":"2017","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2025020710100274800_CIT0015","doi-asserted-by":"publisher","first-page":"2569","DOI":"10.1007\/s00784-017-2056-8","article-title":"Gingival recessions of lower incisors after proclination by orthodontics alone or in combination with anterior mandibular alveolar process distraction osteogenesis","volume":"21","author":"Antonarakis","year":"2017","journal-title":"Clin Oral Invest"},{"key":"2025020710100274800_CIT0016","doi-asserted-by":"publisher","first-page":"146","DOI":"10.5051\/jpis.2020.50.3.146","article-title":"Correlation analysis of gingival recession after orthodontic treatment in the anterior region: an evaluation of soft and hard tissues","volume":"50","author":"Lee","year":"2020","journal-title":"J Periodontal Implant Sci"},{"key":"2025020710100274800_CIT0017","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1093\/ejo\/cjy086","article-title":"Long-term evaluation of lower incisors gingival recessions after orthodontic treatment","volume":"41","author":"Pernet","year":"2019","journal-title":"Eur J Orthod"},{"key":"2025020710100274800_CIT0018","doi-asserted-by":"publisher","first-page":"330","DOI":"10.2319\/080219-510.1","article-title":"A cone-beam computed tomographic evaluation of alveolar bone dimensional changes and the periodontal limits of mandibular incisor advancement in skeletal Class II patients","volume":"90","author":"Matsumoto","year":"2020","journal-title":"Angle Orthodontist"},{"key":"2025020710100274800_CIT0019","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1007\/s00056-020-00263-1","article-title":"Postorthodontic lower incisor and canine inclination and labial gingival recession in adult patients: a prospective study","volume":"82","author":"Kalina","year":"2021","journal-title":"J Orofacial Orthopedics"},{"key":"2025020710100274800_CIT0020","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1111\/j.1601-6343.2010.01491.x","article-title":"Orthodontic therapy and gingival recession: a systematic review","volume":"13","author":"Joss-Vassalli","year":"2010","journal-title":"Orthod Craniofacial Res"},{"key":"2025020710100274800_CIT0021","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s40510-018-0212-6","article-title":"Post-orthodontic lower incisor inclination and gingival recession\u2014a systematic review","volume":"19","author":"Tepedino","year":"2018","journal-title":"Progress Orthod"},{"key":"2025020710100274800_CIT0022","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1002\/JPER.18-0125","article-title":"Gingival thickness assessment at the mandibular incisors with four methods: a cross-sectional study","volume":"89","author":"Kloukos","year":"2018","journal-title":"J Periodontol"},{"key":"2025020710100274800_CIT0023","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1111\/j.1600-051x.1987.tb00954.x","article-title":"Some periodontal tissue reactions to orthodontic tooth movement in monkeys","volume":"14","author":"Wennstr\u00f6m","year":"1987","journal-title":"J Clin Periodontol"},{"key":"2025020710100274800_CIT0024","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1111\/jcpe.12505","article-title":"Effects of facial tooth movement on the periodontium in rats: a comparison between conventional and low force","volume":"43","author":"Danz","year":"2016","journal-title":"J Clin Periodontol"},{"key":"2025020710100274800_CIT0025","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1016\/j.jdent.2010.04.007","article-title":"The width of the attached gingiva\u2014much ado about nothing","volume":"38","author":"Mehta","year":"2010","journal-title":"J Dentistry"},{"key":"2025020710100274800_CIT0026","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1902\/jop.1972.43.10.623","article-title":"The relationship between the width of keratinized gingiva and gingival health","volume":"43","author":"Lang","year":"1972","journal-title":"J Periodontol"}],"container-title":["European Journal of Orthodontics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejo\/article-pdf\/47\/2\/cjaf001\/61789545\/cjaf001.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejo\/article-pdf\/47\/2\/cjaf001\/61789545\/cjaf001.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T10:10:30Z","timestamp":1738923030000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejo\/article\/doi\/10.1093\/ejo\/cjaf001\/8004860"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,7]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2,7]]}},"URL":"https:\/\/doi.org\/10.1093\/ejo\/cjaf001","relation":{},"ISSN":["0141-5387","1460-2210"],"issn-type":[{"value":"0141-5387","type":"print"},{"value":"1460-2210","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,4]]},"published":{"date-parts":[[2025,2,7]]},"article-number":"cjaf001"}}