Gingival Clefts Revisited

Abstract

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.