Association between gingival recession and proclination of maxillary central incisors near the cleft in patients with unilateral cleft lip and palate: A retrospective case-control study

IntroductionThe aim of this study was to investigate whether proclination of the maxillary central incisor near a cleft leads to gingival recession in patients born with unilateral cleft lip and palate.MethodsForty patients with unilateral cleft lip and palate were retrospectively enrolled. By using intraoral slides, casts, and cephalograms, changes in gingival recession and proclination were measured. The 2-sample t test, correlation, and stepwise logistic regression analyses were applied.ResultsThere were statistically significant differences in proclination variations between subjects with and without increased gingival recession (P <0.0001). A positive correlation was shown between proclination and gingival recession. Bone grafting during treatment resulted in a significant difference in gingival recession (P <0.05). Every 2° of increase in the angle between the long axis of the maxillary central incisors and the sella-nasion plane had a 3.06 times greater risk for gingival recession (odds ratio, 3.06; 95% confidence interval, 1.329-7.046; P = 0.0086).ConclusionsProclination of the maxillary central incisor adjacent to the cleft is positively correlated with gingival recession in patients with unilateral cleft lip and palate. Proclination should be limited to prevent gingival recession and its esthetic and functional problems. It is better for a borderline cleft patient to have orthognathic surgery rather than camouflage treatment. Bone grafting during treatment might benefit gingival recession. The angle between the long axis of the maxillary central incisors and the sella-nasion plane is considered the strongest predictor of gingival recession.