“Tissue is the issue, but bone sets the tone.” Roots positioned outside the alveolar bony housing can result in gingival recession and risk of tooth loss. Conversely, orthodontic tooth movement into the alveolar envelope can facilitate improvement of gingival conditions and enhance the prognosis of periodontal plastic surgery. The presentation will focus on treatment planning, biomechanical considerations, and appliance design relevant to the interdisciplinary management of gingival recession. Different appliances need different approaches and proper appliance selection may influence the biomechanical work flow and treatment outcome. What may be the difference between fixed appliances and aligners in torque control of roots with recession and thin gingival phenotype in a thin alveolar housing. Clinical cases will illustrate how orthodontic interventions, in close collaboration with a periodontal specialist, can effectively reposition displaced roots and contribute to the management of gingival recession.