Orthodontic tooth movement, particularly vestibular movement and arch expansion, can induce changes in the marginal periodontal tissues, with the risk of gingival recession being closely related to the initial tissue phenotype. A thin phenotype represents a predisposing factor for the onset or worsening of bone dehiscence and recession during and after orthodontic therapy. These can result in various clinical conditions, such as aesthetic alterations, root sensitivity, and difficulties maintaining oral hygiene, which, if they progress, could compromise the prognosis of the affected teeth. The presentation will focus on the bidirectional interaction between dental movement during orthodontic treatment and periodontal phenotype, analyzing different clinical scenarios and distinct therapeutic moments: when to surgically modify the phenotype and treat post-orthodontic gingival recessions and, conversely, when orthodontic treatment can improve the prognosis and outcome of mucogingival therapy.