Prioritization of risk factors of gingival hyperplasia during orthodontic treatment: the role 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 risk factors Methods: This comprehensive cross-sectional descriptive study was conducted on 193 orthodontic patients in good general 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 attachment, they alloys used for the arches and the type of ligatures. Descriptive statistics were carried out, then univariate analyses were achieved thanks to cross sectional tables and lastly, a multivariate analysis allowed a hierarchization of the risk factors. Results: Gingival growth occurred for 49.7% of patients included. The risk factors for this pathology during fixed orthodontic treatment were conventional metal brackets (OR = 3.5), oral ventilation (OR = 3), male gender (OR = 2.2), thick periodontium (OR = 2) and elastomeric ligations (OR = 2). After achievement of the logistic regression, the amount of plaque would not be directly related to the development of this gingival increase. Conclusions: Among the risk 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.