The effect of orthodontic treatment on plaque and gingivitis T. M. Davies," W. C. Shaw," H. V. Worthington," M. Addy, ~ P. Dummer, b and A. Kingdon b

Manchester, England, and Cardiff, Wales The aim of the present investigation was to evaluate the relationship between the receipt of orthodontic treatment and subsequent periodontal health. Data from 417 children who were classified at baseline as having significant occlusal variations and who were present at the follow-up examination 3 years later were selected from an original cohort of 1015. One hundred fourteen of these children received orthodontic treatment over this time period and provided two groups of children for comparison in this study. Plaque indices, bleeding indices, and degree of dental irregularity were recorded for each incisor and canine tooth. There were significant reductions in the plaque and gingivitis scores on all tooth surfaces between the baseline and 3-year examination in the two groups of children. The children who had received orthodontic treatment had the greater reduction, but this appeared to be more related to behavioral factors than to improved tooth alignment. (AMJ ORTHOD DENTOFACORTHOP 1991 ;99:155-62.)

A l t h o u g h it might be reasonable to suppose that poorly aligned teeth may complicate oral hygiene procedures and lead to increased plaque accumulation and subsequent gingival inflammation, these associations have not been unequivocally established by research. These circumstances provided part of the background for a longitudinal multidisciplinary study of associations between malocclusion and a range of sociopsychological and dental health issues. The strategy for investigation ~describes the sampling technique and the indices of caries, periodontal status, mandibular function, occlusal status, and socibpsychological features. Comprehensive data for a cohort of 1015 subjects, 11.5 to 12.5 years old, weighted to include occlusal features of low prevalence but high orthodontic interest, were obtained in 1981. Eight hundred of the subjects were reexamined in 1984, and further assessments into adulthood are projected. Preliminary analysis of the periodontal data for the cohort at baseline has been reported, 2 and a number of clear findings have emerged. It was found that none of the subjects were plaque-free and all of the subjects exhibited some bleeding on probing, which showed a 100% prevalence for gingivitis as measured by this parameter. The range showed that some children had bleeding at a few sites, whereas others bled at every site that was probed.

From the 'University Dental Hospital, Manchester, England, and bthe Universit)' of Wales College of Medicine, Cardiff, Wales. Supported by DHSS Grant JR 128/28 BLG. 811119275

Also, it was found that girls generally had lower plaque and gingivitis scores than boys, and among the boys plaque levels were associated with social class. Additional reports of the associations between occlusal variations and periodontal status and caries 3 at baseline indicate that there was a modest but significant positive correlation between the subjects' mean plaque and mean irregularity indices. Irregular teeth retained more plaque than straight teeth by a modest though statistically significant extent, but no significant differences in the incidence of gingivitis or dental caries were found. The aim of this investigation was to examine associations at 15 years, between previous receipt of orthodontic treatment and maxillary and mandibular plaque accumulation and gingivitis. METHODS Sample

For this investigation, data were selected from 417 children who were classified at baseline as having specific occlusal conditions that might require orthodontic treatment and who were present at the follow-up examination 3 years later.' It was then possible to determine which of these children received orthodontic treatment over this period, which provided two groups of children for comparison. Children who were still wearing active orthodontic appliances or retainers at the 3year examination were excluded. Fixed appliances were employed in the majority of patients, but in 26%, maxillary removable appliances were used for certain corrections.

155

156

Davies et al.

Am. J. Orthod. Dentofac. Orthop. February 1991

Table I. Occlussal conditions at baseline of children in the study subgroup, cross tabulated by whether or not they went on to receive orthodontic treatment Orthodontic treatment No

Yes

Occlusal conditions

N

Deep overbite Prominent incisors Partial anterior crossbite Total anterior crossbite General anterior spacing Midline space Missing incisor Exposed maxillary gingivae Severe anterior crowding Total

I

(%)

8 20 29 3 6 1 8 1 3__88 114

(%)

30 28 71

(7) (I 8) (25) (3) (5) (l) (7) (1) (33) (100)

9 22 9 33 26 75 I 303

(10) (9) (23) (3) (7) (3) (11) (9) (25) (100)

Table I!. Comparison between children who went on to receive orthodontic treatment and those who did not, for baseline plaque and gingivitis scores Orthodontic treatment Yes (N = 114)

No (N = 303)

Baseline indices

Mean

SD

Mean

SD

t Value (DF = 415)

p Value

Buccal plaque Lingual plaque Buccal bleeding Mesial bleeding Lingual bleeding

1.37 0.96 0.56 0.51 0.51

(0.53) (0.34) (0.22) (0.24) (0.19)

1.51 0.96 0.62 0.55 0.53

(0.55) (0.33) (0.25) (0.25) (0.19)

- 2.2 0. ! - 2.2 - 1.2 - 0.9

The effect of orthodontic treatment on plaque and gingivitis.

The aim of the present investigation was to evaluate the relationship between the receipt of orthodontic treatment and subsequent periodontal health. ...
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