Dimitris Kloukos

Dimitris Kloukos, Athens/Bern

CURRICULUM VITAE

Dimitris Kloukos graduated from the Dental School of the Aristotle University οf Thessaloniki, Greece and the Military Medical Academy for Officers in 2003. He specialized in Orthodontics at the University of Bern, Switzerland under Prof. Christos Katsaros, receiving the title ‘Master of Science in Orthodontics’ (2009-2013). He has been awarded with the title of Doctorate at University of Bern, Switzerland (Dr. Med. Dent. in Dentistry in 2011). He has achieved a second Master title (Master of Science in Clinical Trials) at the University of London, United Kingdom (2011-2015). He is currently Major of Greek Air Force and Head of the Orthodontic Department of the 251 Hellenic Air Force General Hospital, Athens, Greece and holds a private practice in Athens. He is also Senior Lecturer and Research Associate of University of Bern and working for a second doctorate title (PhD) in Department of Periodontology, University of Malmö, Sweden. He has published over 40 articles in international journals and book chapters in the fields of orthodontic materials, clinical trials and research methodology. He acts as a reviewer in numerous peer-reviewed journals and his scientific interests in current research projects mainly include clinical research methodology and the various aspects of orthodontic-periodontal inter-relationship.

ABSTRACT

Timing of soft tissue augmentation: before or after the orthodontic treatment?

The issue of incisor proclination outside their dentoalveolar envelope as a source of gingival recession has been considered for years. Although it is broadly believed that mandibular incisor proclination leads to gingival recession, there are very few clinical studies that have actually investigated this. Some of them have shown gingival recession to be associated with proclination of the mandibular incisors whereas others have found no such correlation. Periodontal prevention of gingival recessions in orthodontic patients remains, likewise, contradictory. Historically, periodontists have indicated pre-treatment gingival augmentation to recreate the zone of attached gingiva. The early concept for this approach was that attached gingiva is important to dissipate the force of muscle pull and unattached mucosa. Opposite to this preventive concept, however, some clinicians consider this approach as over-treatment and prefer to wait until the potential gingival recession becomes a pathological and clinical entity. Subsequently, the developed recession may be treated during or after orthodontic therapy. Therefore, and despite the clinical experience that soft tissue augmentation of bucco-lingual gingival dimensions before orthodontic treatment may be a clinically viable treatment option in patients considered at risk, this treatment approach is not yet based on solid scientific evidence. The aim of this presentation is to assess the available literature and appraise if, first of all, soft tissue augmentation is indicated for prevention or treatment of gingival recession, and at which point of time related to orthodontic treatment, when a change in the inclination of the incisors is anticipated.