International Journal of Clinical Research

Among oral health problems, gum recession and teeth loss are common phenomena. These conditions not only affect peoples ability to eat, but also may change their facial contours. According to case records and examination reports in the hospital, we found that when gums become thinner and atrophy or teeth fall, many people will experience sagging cheeks and blurred chin lines. In recent observations, we followed and investigated 85 patients with different severity gingival problems and dental missing problems, and used measurement tools to record the depth of their cheek depression and the arc of the mandible edge, while comparing them with the internal examination results of the oral cavity [1,6]. According to statistical results, the more severe the patients gingival recession, the more severe the skin sagging on the cheeks. For example, a patient caused alveolar bone to be absorbed due to long-term gingival inflammation, and the depression area below the entire cheekbones is about 3 mm deeper than that of normal people [3]. In addition, the number of teeth missing is also related to the blurred jawline. Especially when more than 3 teeth are missing, the arc-shaped contour of the mandibular angle often becomes unclear, which is more obvious in female patients [5,9]. The possible reason is that after the teeth are missing, the bone tissue that originally supported the face gradually loses, just like if the house loses the load-bearing wall, the skin and muscles on the surface will sag [7]. It is worth noting that people of different ages are affected differently. If young patients experience teeth loss, due to the high content of collagen on their face, they may not experience significant sagging in the short term. However, among patients over 40 years old, the number of missing teeth shows a significant positive correlation with the degree of facial relaxation, which may be related to the natural aging process of human beings [13,20]. A 52-year-old female patient not only had difficulty chewing because of multiple front teeth, but even the corners of her mouth sag unconsciously when she spoke. After half a year of dental implant repair, the facial lines gradually returned to nature [10,27]. In terms of treatment, timely repairing missing teeth or performing gingival regeneration treatment is helpful for maintaining facial shape. For example, restoring the alveolar bone height through bone increment surgery, or increasing the thickness of the gums with connective tissue transplantation can effectively improve facial relaxation problems [16,34]. However, these treatment methods require the formulation of plans based on the specific situation of the patient. For example, a patient suffered from mandible defects due to trauma, the doctor used digital guide technology for precise implantation, and the postoperative occlusal function and facial appearance were well restored [12,28].There are also some shortcomings in this study, such as the insufficient number of samples and the observation time is short. In the future, more information on patients in different regions and living habits needs to be collected, especially long-term tracking of changes in the effect after treatment. If an early warning model of gum health and facial aging can be established, it will be of great help to preventive treatment [8][18]. In addition, new advances have been made in research on gingival self-repair materials, which may provide more options for clinical treatment [36,40].

Gingival recession; Teeth missing; Face depression and sagging; Fuzzy jawline; Clinical observation