Estimating effects of craniofacial morphology on gingival recession and clinical attachment loss

J Clin Periodontol. 2017 Apr;44(4):363-371. doi: 10.1111/jcpe.12661. Epub 2017 Feb 18.


Objectives: Evidence on possible associations between facial morphology, attachment loss and gingival recession is lacking. We analysed whether the facial type, which can be described by the ratio of facial width and length (facial index), is related to periodontal loss of attachment, hypothesizing that a broad face might be associated with less gingival recession (GR) and less clinical attachment loss (CAL) than a long face.

Materials and methods: Data from the 11-year follow-up of the population-based Study of Health in Pomerania were used. Periodontal loss of attachment was assessed by GR and CAL. Linear regression models, adjusted for age and gender, were used to assess associations between specific landmark based distances extracted from magnetic resonance imaging head scans and clinically assessed GR or CAL (N = 556).

Results: Analysing all teeth, a higher maximum cranial width was associated with a lower mean GR (B = -0.016, 95% CI: -0.030; -0.003, p = 0.02) and a lower mean CAL (B = -0.023, 95% CI: -0.040; -0.005, p = 0.01). Moreover, a long narrow face was significantly associated with increased mean GR and CAL (facial index, P for trend = 0.02 and p = 0.01, respectively). Observed associations were more pronounced for incisors and canines than for premolars and molars.

Conclusion: This study revealed craniofacial morphology, specifically the cranial width and the facial index, as a putative risk factor for periodontal loss of attachment.

Keywords: clinical attachment loss; craniofacial morphology; gingival biotype; gingival recession; magnetic resonance images.

Publication types

  • Comparative Study

MeSH terms

  • Cephalometry
  • Face / anatomy & histology*
  • Female
  • Follow-Up Studies
  • Gingival Recession / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Periodontal Attachment Loss / epidemiology*
  • Skull / anatomy & histology*
  • Time Factors