Presence of Gingival Recession After Orthodontic-Orthognathic Approach: A Systematic Analysis of the Available Studies

Background and Objectives: Combined orthodontic–orthognathic treatment is the standard approach for managing severe dentofacial deformities. Nevertheless, its potential impact on periodontal tissues, particularly gingival recession, remains a matter of clinical concern. This study aimed to evaluate the relationship between orthodontic–orthognathic procedures and gingival recession based on available clinical evidence, with particular focus on potential risk modifiers, including orthodontic mechanics, surgical factors, and periodontal phenotype. Materials and Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Me-ta-Analyses (PRISMA) 2020 guidelines. The review question was formulated using the PICO framework. Results: Across the seven included studies, the presence and extent of gingival recession following combined orthodontic–orthognathic treatment varied according to surgical procedure, adjunctive therapy, and patient-specific factors. Conclusions: The risk of gingival recession appears to be related primarily to periodontal phenotype and orthodontic tooth movement (especially in the mandibular incisor region) rather than to orthognathic surgery itself. Careful interdisciplinary planning and peri-odontal risk assessment may help reduce postoperative gingival recession.