Some factors associated with open gingival embrasures following orthodontic treatment

Open gingival embrasures or “black triangles” can be an undesirable outcome of adult orthodontic treatment. The aims of the present study were to determine the prevalence of open gingival embrasures in a group of orthodontic patients, and to determine if open gingival embrasures were related to: age at the start of treatment, the severity of pretreatment crowding of the mandibular incisors, the duration of treatment or changes in alveolar bone height. The subjects were 80 orthodontic patients (33 males, 47 females) between 15 and 31 years of age. Open gingival embrasures were found in 43.7 per cent of all subjects, while in subjects over 20 years of age the prevalence was 66.7 per cent. In relation to the amount of crowding 42.8 per cent of the subjects with less than 4 mm crowding had open gingival embrasures, 41.2 per cent of those with between 4 and 8 mm crowding had open gingival embrasures, and 50 per cent of those with more than 8 mm crowding had open gingival embrasures. The groups were not significantly different. Approximately 42 per cent of the subjects in the shorter treatment group had open gingival embrasures, and 44.4 per cent of those whose treatment took longer than 3 years had open gingival embrasures. This difference was not statistically significant. Cephalometric measurements of mandibular alveolar bone height indicate that open gingival embrasures were more likely to be due to resorption of the alveolar crest rather than extrusion of the mandibular incisors. In conclusion, open gingival embrasures were more frequently found in patients over 20 years of age than in younger patients, and were associated with resorption of the alveolar crest.