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ORIGINAL ARTICLE |
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| Ahead of print
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| Prevalence of periodontal diseases in orthodontic patients |
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Ujjwal Priyadarsi1, Mohammad Shahbaz Alam2, Abid Hussain3, Farrukh Azam4, Priyanka Kumari5, Md Abu Nafe6
1 Senior Resident, Department of Dentistry, PMCH, Dhanbad, Bihar, India
2 Senior Lecturer, Department of Periodontology and Oral Implantology, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India
3 Department of Orthodontics, Mithila Minority Dental College and Hospital, Darbhanga, Bihar, India
4 Professor and HOD, Department of Dentistry, PMCH, Dhanbad, India
5 Consultant Orthodontist, Department of Orthodontics, Brahmanad Narayana Hospital, Jamshedpur, Jharkhand, India
6 Department of Periodontology and Oral Implantology, Mithila Minority Dental College and Hospital, Darbhanga, Bihar, India
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| Date of Submission | 23-Sep-2020 |
| Date of Acceptance | 03-Oct-2020 |
| Date of Web Publication | 27-Nov-2020 |
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Objective: The objective was to investigate the association between orthodontic treatment and periodontitis in a representative sample of Jharkhand.
Methodology: The clinical examinations at six sites per tooth were assessed using visible plaque index (VPI), gingival bleeding index (GBI), bleeding on probing (BOP), periodontal probing depth (PPD), and clinical attachment loss (CAL). A manual Williams probe (Neumar, São Paulo, Brazil) was used, except for the VPI. Data analysis was done.
Results: The median percentage values of sites positive for VPI, GBI, and BOP were calculated for each group and compared using a Mann–Whitney test and the mean values for PPD and CAL with a Student's t-test. Intragroup comparisons between teeth were performed with Tukey's analysis of variance. The level of significance was set at 5%.
Conclusion: The use of orthodontic appliances is not necessarily related to worsening periodontal conditions. The results of the present study reinforce the importance of susceptibility to periodontal disease independent of the presence of a well-known retentive plaque factor, i.e., orthodontic appliances and/or bands.
Keywords: Orthodontic patients, periodontal diseases, periodontitis
How to cite this URL:
Priyadarsi U, Alam MS, Hussain A, Azam F, Kumari P, Nafe MA. Prevalence of periodontal diseases in orthodontic patients. Int J Prev Clin Dent Res [Epub ahead of print] [cited 2023 Mar 28]. Available from: https://www.ijpcdr.org/preprintarticle.asp?id=301705 |
| Introduction | |  |
The relationship between orthodontic procedures and periodontal status is considered a challenge, especially periodontal health during and after orthodontic treatment. Several studies have addressed the impact of fixed, removable, and myofunctional orthodontic/orthopedic appliances or retainers in relation to supragingival plaque accumulation and gingivitis.[1],[2],[3] On the other hand, banded appliances are possible modifying factors in periodontal supporting tissues. It has been advocated that these alterations may directly be related to the subgingival location of the bands resulting in the destruction of not only the supra-alveolar tissues but also, in some cases, the bone crest. The aim of the present study was, therefore, to evaluate periodontal conditions in patients who had undergone orthodontic therapy with fixed appliances, to determine the condition between banded and unbanded molars, and to compare the finding with the periodontal status in a group of untreated patients.[4],[5],[6],[7]
| Methodology | | |
One hundred selected patients, after written informed consent was obtained, constituted the study population. They were divided into a treated and a control group. Individuals who underwent fixed orthodontic therapy with banded first molars constituted the treated group (n = 50, 64% female, mean age 23.00 ± 2.04 years). The control group comprised 50 individuals who had not undergone orthodontic therapy (51.72% female, mean age 23.99 ± 2.46 years). All participants were healthy, had never smoked, had no history of periodontitis before or during orthodontic therapy, had at least 20 teeth including molars, premolars, and canines without proximal or buccolingual restorations, and did not use chemical plaque control agents. The clinical examinations, performed by one examiner (SLV) blinded to the orthodontic history of the individuals, at six sites per tooth were assessed using the visible plaque index (VPI) and gingival bleeding index (GBI), and periodontal probing depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP). A manual Williams probe (Neumar, São Paulo, Brazil) was used, except for the VPI.
| Results | | |
The median percentage of sites positive for VPI, GBI, and BOP. The VPI values were 1.75 for both groups. For the GBI, the treated group showed a median value of 0.85 (±1.71) and the control group 1.14 (±2.13). BOP median values (0.83) were the same for both groups. For all parameters, no statistically significant differences were observed between the groups. The mean values for PPD are shown in [Table 1]. For the molars, both groups showed mean values around 1.50–1.60 mm. No significant intra- or intergroup differences were observed (banded versus unbanded molars). However, the premolars and canines differed from the molars in both groups, and in the control group, the mean PPD for the canines was statistically different.
Comparisons between groups did not reveal any significant differences for CAL. For the control group, no significant differences were found. The mean values (standard deviation) for CAL, in millimeters, in the treated and control groups. No statistically significant differences were observed between the treated and control groups (Student's t-test, α = 0.05). In the treated group, the first molars differed from the canines. In the control group, no statistically significant difference was observed between teeth.
| Discussion | | |
The present study compared the periodontal conditions of orthodontically and untreated individuals. The results showed similar periodontal conditions for both groups and suggested an absence of permanent periodontal damage, traditionally related to fixed appliances and to banded molars, at least in nonsusceptible patients. The findings showed low levels of plaque and gingivitis in both groups, with no intergroup differences. It has been established that marginal and subgingival signs of inflammation are associated with gingivitis and periodontitis. The findings suggest that the presence of fixed appliances with banded molars does not permanently influence inflammation.[8.9] Thus, it seems that the quantitative and qualitative differences in subgingival microbiota and inflammatory markers do not result in permanent changes. The observed mean CAL in the present study was not different either for banded or for unbanded teeth, or between the groups. In the present study, it can be argued that patients may show higher levels of oral hygiene than otherwise comparable populations.[10] Within the characteristics and the well-known limitations of cross-sectional studies, it can be speculated that even in patients where differences in PPD and CAL were observed among the groups of teeth, the clinical impact of the differences might be questioned. Differences between statistical significance and clinical relevance are still a matter of discussion.
| Conclusion | | |
The use of orthodontic appliances is not necessarily related to worsening periodontal conditions. The results of the present study reinforce the importance of susceptibility to periodontal disease independent of the presence of a well-known retentive plaque factor, i.e., orthodontic appliances and/or bands.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
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| 8. | Bragger U, Lang NP. The significance of bone in periodontal disease. Semin Orthod 1996;2:31-8. |
| 9. | Romero M, Albi M, Bravo LA. Surgical solutions to periodontal complications of orthodontic therapy. J Clin Pediatr Dent 2000;24:159-63. |
| 10. | Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontol 2000 2013;62:59-94. |
Correspondence Address:
Ujjwal Priyadarsi,
Senior Resident, Department of Dentistry, PMCH, Dhanbad, Jharkhand
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/ijpcdr.ijpcdr_43_20
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