The main motivations in the performance of an orthodontic treatment is the long term stability of the tissue involved. Therefore the need of orthodontic and periodontal evaluation for longevity of the dentition and preservation of supporting tissue has become of great importance.

The correct diagnosis involves multiple developmental factors: the study of the cortical plate thickness, arch width and length, crowding, rotations, attached gingival, papilla, ectopic eruptions, labial inclination, habits, frenum position, and patient´s hygiene.

The lost of lower vestibular cortical bone will produce the exposure of the roots at different scales of severity, which could be prevented if the diagnostic considerations were stress carefully prior to treatment.

Numerous authors recommend protecting the area with gingival graft before the orthodontic treatment. In this study, 25 patients were treated by connective tissue grafts palate utilizing an incision at the depth of the vestibule, elevating the tissues under the periostioum without detaching the gingival margin. The incisors inclination was corrected after the connective tissue graft. Some others recommend the graft after orthodontics, in some cases the necessity of extractions and a second treatment will be a necessity.

The connective tissue graft to the anterior mandible improves the gingival biotype, allowing the orthodontist to increase the incisor to mandibular plane angle without
recessions or lack of adequate soft tissue thickness. Samples will be presented.