Prioritization of predisposing factors of gingival hyperplasia during orthodontic treatment: the role of amount of biofilm

Abstract

Background The mechanism of gingival growth that may occur during fixed orthodontic treatment is not yet fully understood and the amount of dental plaque is often incriminated. The objective of this study was to evaluate the prevalence of gingival growth during multi-attachment orthodontic treatment and to prioritize its predicting factors, especially the quantity of biofilm. Methods This comprehensive cross-sectional descriptive study was conducted on orthodontic patients aged 9 to 30 years, in good health, treated by a fixed appliance. Periodontal clinical parameters such as plaque index, gingival index, probing pocket depth, periodontal phenotype and gingival enhancement index were recorded. Likewise, the brushing habits and the date of the last scaling were noted. The orthodontic parameters studied were the duration of the treatment, the type of bracket, the alloys used for the arches and the type of ligatures. Descriptive statistics were carried out, and variables presenting p value < 0.25 were included in a multivariate analysis to calculate the Odds Ratio (OR) of gingival enlargement”. Results A total of 193 patients were included (16.38 ± 4.89 years). Gingival growth occurred for 49.7% of patients included. The predisposing factors for this pathology during fixed orthodontic treatment were conventional metal brackets (p = 0.021), mouth breathing (p = 0.040), male gender (p = 0.035), thick periodontal phenotype (p = 0.043), elastomeric ligations (p = 0.007), duration of treatment (p = 0.022) and presence of plaque (p = 0.004). After achievement of the logistic regression, only two factors remained related to gingival enlargement: metallic brackets (OR: 3.5, 95% CI: 1.1–10.55) and duration of treatment (OR: 2.03, 95% CI: 1.01–4.08). The amount of plaque would not be directly related to the development of gingival increase during orthodontic treatment. Conclusions Among the predisposing factors that underlie gingival growth during multi-attachment therapy, the amount of plaque is not found. The qualitative assessment of the plaque and its evolution during treatment could clarify the role of the biofilm in the occurrence of gingival overgrowth.

Clinical, histopathological and immunohistochemical changes of the superficial marginal periodontium caused by orthodontic treatment with fixed metallic orthodontic appliances

“…We believe that microscopic changes in our group are caused by both the mechanical force caused by the orthodontic appliances, but also by the bacterial plaque. It is known that the use of orthodontic brackets leads to changes in the composition of the bacterial plaque, both quantitatively and qualitatively, also increasing the risk of periodontal infection [ 29 , 30 ]. By preventing access to good oral hygiene and creating microbial niches, orthodontic brackets prevent good oral hygiene, resulting in a serious threat to periodontal health [ 31 ].…”

Controlling the size of GO in GO/nAg nanocomposite coatings on orthodontic nickel–titanium alloy toward excellent anti-corrosion, antibacterial, and tribological properties

“…The complex structure of the fixed appliance is appealing for cariogenic bacteria to attach and produce acid. 57 Acid production not only leads to enamel demineralization and dental caries but also accelerates the corrosion of orthodontic appliances and in turn further increases the surface roughness. 58 The current study evaluated the antibacterial property of GO/ nAg coatings using the typical cariogenic bacterium S. mutans.…”

Soft tissue lasers: an innovative tool enhancing treatment outcomes in orthodontics – a narrative review

“…This may cause gingival hyperplasia, which makes oral hygiene maintenance considerably complicated. 17 or less severe gingival hyperplasia can be performed using diode or CO 2 laser, but in severe conditions only CO 2 should be attempted. Even though diode lasers are effective in melting tiny regions of gingiva, their slow cutting speed and method of action, which involves melting tissue at temperatures ranging from 750-1250° Celsius render the procedure inefficient and time-consuming.…”