Mucogingival changes resulting from mandibular incisor tooth movement.

This study involved a cephalometric analysis of 1,150 fully treated orthodontic cases evaluated by Kodachrome slides, plaster casts, and cephalometric films to determine changes in the width of keratinized gingiva relative to lower incisor tooth movement and to ascertain the incidence of mucogingival problems in orthodontic patients. It was apparent that in a small percentage of cases visible mucogingival changes occurred and could be statistically correlated with the magnitude and direction of tooth movement. In this group of patients 1.3 percent (sixteen) showed a decrease in the width of keratinized gingiva with either minimal movement or some labial movement of the mandibular incisors; 0.69 percent (eight) had an increase in keratinized gingival width concomitant with significant lingual positioning of the lower incisors. The salient point to be made is that with an initial minimal or inadequate width of keratinized gingiva (0 to 2 mm.), mandibular incisor tooth movement over a period of treatment could significantly affect the final quality of gingival health in the critical mandibular anterior region.