Impact of Obesity on Orthodontic Tooth Movement in Adolescents: A Prospective Clinical Cohort Study

Abstract

Obesity is a widespread chronic inflammatory disorder characterized by an increased overall disease burden and significant association with periodontitis. The aim of this prospective clinical cohort study was to investigate the effect of obesity on orthodontic tooth movement. Fifty-five adolescent patients (27 males, 28 females) with a mean (SD) age of 15.1 (1.7) years and mean (SD) body mass index (BMI) of 30.2 (3.5) kg/m in obese and 19.4 (2.2) kg/m in normal-weight groups were followed from start of treatment to completion of tooth alignment with fixed orthodontic appliances. Primary outcome was time taken to complete tooth alignment, while secondary outcomes included rate of tooth movement and change in clinical parameters (plaque/gingival indices, unstimulated whole-mouth salivary flow rate, gingival crevicular fluid biomarkers). Data collection took place at baseline (start of treatment: appliance placement), 1 h and 1 wk following appliance placement, and completion of alignment. Results were analyzed by descriptive statistics followed by generalized estimating equation regression modeling. There were no significant differences between groups in time taken to achieve tooth alignment (mean [SD] 158.7 [75.3] d; P = 0.486). However, at 1 wk, initial tooth displacement was significantly increased in the obese group ( P < 0.001), and after adjusting for confounders, obese patients had a significantly higher rate of tooth movement compared with normal-weight patients (+0.017 mm/d; 95% confidence interval, 0.008-0.025; P < 0.001) over the period of alignment. Explorative analyses indicated that levels of the adipokines leptin and resistin, the inflammatory marker myeloperoxidase (MPO), and the cytokine receptor for nuclear factor kappa-B ligand (RANKL) were significantly different between obese- and normal-weight patients and associated with observed rates of tooth movement. This represents the first prospective data demonstrating a different response in obese patients compared with normal-weight patients during early orthodontic treatment. These differences in the response of periodontal tissues to orthodontic force in the presence of obesity have potential short- and long-term clinical implications.

Obesity and orthodontic treatment: is there any direct relationship?

“…The analysis carried out by Saloom et al 19 reveals an increase in the rate of tooth movement, especially during the first week, but the rate of orthodontic alignment finishing remained the same. In the last paragraph, the article concludes: Obese patients need less time for completion of tooth alignment in comparison to normal-weight patients; however, such finding is not statistically significant.…”

“…Recently, Saloom et al 19 sought to obtain evidence showing that tooth movement in obese patients would occur within a shorter period of time up to the moment when alignment would be achieved by means of fixed appliances. However, in order to gather such probable data, the authors compared 28 normal-weight adolescents with 27 obese ones, a quite small sample of patients, especially if obesity-related variables as well as parallel diagnoses and orthodontic movement-related variables were taken into consideration.…”

“…The first study aiming at establishing a connection between obesity and the rate of induced orthodontic tooth movement was conducted by Saloom et al; 19 however, it could not effectively nor significantly reveal any direct influence or effect. Despite being identified during the first week, differences could not be explained and treatment time remained unchanged.…”

Pharmacology: Sea change of indications

“…1 Some years ago we too were able to carry out a research project in our practice. [2][3][4] We were then working in an NHS funded by fee-per-item, which allowed a flexibility of approach to finance not possible in today's target driven, contracted service.…”

Association between obesity and adipokines levels in saliva and gingival crevicular fluid: A systematic review and meta‐analysis

“…Recently, the literature has shown associations between obesity with dental caries, changes in dental eruption, and periodontal disease . Accordingly, significant changes in the levels of adipokines in saliva and gingival crevicular fluid (GCF) of individuals with obesity have been observed …”