Buccal malposition of teeth may be the result of excessive tooth/teeth proclination beyond the cortical bone as a consequence of specific anatomic conditions, or created (or worsened) by orthodontic movement

In these cases, the occurrence of gingival recession is often associated with poor mucogingival characteristics (e.g. the apical third of the root may become transparently visible through the extremely thin alveolar mucosa, the keratinized tissue apical and lateral to the root surface

may be lost completely and the soft tissue apical to the root exposure may become probeable). As a result of these poor mucogingival conditions and root malpositioning, root-coverage surgical techniques become very challenging and complete root coverage is unpredictable . The orthodontic repositioning of root(s) within the limits of the alveolar bone may alter the prognosis of root-coverage procedures as the surgical procedure becomes easier to perform as a result of the improved quality and quantity of the keratinized tissue apical and lateral to the exposed root.