• Gingival Clefts Revisited

      Geiman, Robert; Stappert, Dina (2015)
      Background: Gingival clefts commonly occur during orthodontic space closure of bicuspid extraction sites. The etiology of clefts is not fully agreed upon in the literature. Purpose: To investigate factors that predispose subjects to gingival clefts, and to confirm existing research in regards to the incidence and severity of gingival clefts. Results: The incidence of gingival clefts (N=91) was 71.4%. Extraction sites from Whites (n=16) had the highest incidence (93.8%) (p=0.011) and severity of clefts (29.15 mm2) (p=0.011). Slower rates (n=35) of space closure (<.6 mm/mo) yielded larger clefts(severity= 26.50 mm2), while faster(n=18) space closure (>1.2 mm/mo) yielded smaller clefts (Severity =17.85 mm2). Sites that had <1mm, of bone thickness, 3mm apical from the crest had mean severity of 29.16 mm2, while sites that had ≥2mm of bone thickness had a mean severity of 17.45 mm2. Conclusions: Gingival clefts remain common today. Although various parameters show correlation to both severity and incidence of clefts, all patients undergoing space closure after extraction are at risk, and should be monitored.
    • Prospective Clinical Investigation of Orthodontic Relapse from Gingival Clefts

      Scott, Christopher Jason; Stappert, Dina (2018)
      Background: Orthodontic space closure following premolar extraction may result in gingival cleft formation. This may contribute to orthodontic relapse due to reopening of extraction spaces. Aim: 1) To evaluate the effects gingival clefts have on relapse and opening of closed extraction spaces after orthodontic treatment. 2) To record any changes in cleft severity. 3) To establish any relationship between gingival phenotype and cleft severity. Methods: Subjects recruited from previous study in which the occurrence and severity of gingival clefts were measured during space closure. The clinical measures included the occurrence and severity of clefts and their relationship to gingival phenotype. Results: Sites with a cleft (N=42) had 42.86% relapse and those without (N=19) had 36.84% relapse. Conclusions: As cleft severity increases; the amount of relapse distance is likely to increase. Adult patients are at greater risk for relapse at extraction sites compared to adolescent patients.