Innovative Procedure Paves Way for Safer Orthodontics in Patients with Receding Gums
A groundbreaking case at the University of Rochester’s Eastman Institute for Oral Health (EIOH) is helping rewrite the rules for how patients with receding gums can safely undergo orthodontic treatment.
For patients with gum recession, moving the teeth can bring extra risks. When teeth are shifted without proper precautions, the gums can recede even further – leading to discomfort, sensitivity, or even tooth loss. Traditional approaches often involve fixed braces combined with surgical cuts and grafts of bone and soft tissue to protect the teeth and gums.
But in a case recently published in Clinical Advances in Periodontics, a team at EIOH successfully treated a patient with advanced gum recession using clear aligners instead of traditional braces, possibly the first documented case of this procedure that did not require soft tissue grafting.
“This case is significant because it shows how we can combine advanced digital planning, surgical techniques, and modern orthodontics to create safer, more comfortable options for patients who were once considered a high risk,” said Dr. Elli Anna Kotsailidi, program director for the EIOH Periodontics Residency Program.
This case required a carefully choreographed treatment plan for this patient, whose gum recession was caused by aggressive tooth brushing combined with angling of the teeth.
Dr. Kotsailidi and Dr. Dimitrios Michelogiannakis, program director for the EIOH Orthodontics Residency Program thoughtfully developed the treatment plan using 3D scans and digital modeling. Involving residents in both specialties every step of the way, they mapped out a sequence of procedures that included surgical cuts in the jaw to help the bone move with the teeth, bone grafting, and a series of customized clear aligners – changed out every three days – to gradually reposition the teeth.
“Using clear aligners provided a major benefit compared to traditional braces,” said Dr. Michelogiannakis. “Traditional braces can trap food and bacteria, which is especially risky for patients with gum issues. Clear aligners can be removed for brushing and flossing, helping keep the teeth and gums healthy during treatment.”
The entire treatment lasted over a year and required careful coordination between the surgical and orthodontic components. The surgical procedures enhanced the bones and tissues, but also accelerated alignment. Without the surgical enhancement, this treatment would normally take up to three years. In the end, the patient achieved a perfect smile and gums, without having to undergo soft tissue grafting.
“This case opens the door to a new way of thinking about interdisciplinary treatment for patients with complex gum conditions,” said Dr. Kotsailidi.
“And we hope it encourages more research into combining clear aligner therapy with surgical support.,” added Dr. Michelogiannakis.
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