orthodontic appliances | Acta Medica Marisiensis

Clinical Study on the Perception of Patients with Orthodontic Appliances Regarding the Periodontal Change

Simina Chelărescu¹, Karina Dombi¹, Oana Gânscă², Irinel Panainte², Cristian Olteanu³, Mariana Păcurar²

1. Periodontological Department, Faculty of Dentistry, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
2. Orthodontic Department, Faculty of Dentistry, University of Medicine, Pharmacy, Science and Technology of Targu Mures, Romania
3. Orthodontic Department, Faculty of Dentistry, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Romania

DOI: 10.2478/amma-2019-0021

Introduction: The orthodontic treatment helps in reestablishing a functional occlusion, improving the aesthetics and functionality of the dento-facial complex. A correct alignment of the teeth, through the correction of some dental or skeletal anomalies, enhances the possibilities of dental hygiene, thus reducing the risk of periodontal affections. Nevertheless, the presence of orthodontic appliances in the oral cavity may reduce the efficacy of the means of oral hygiene by creating retentive areas for food, thus producing damages at the level of the marginal periodontium.
Objective: The evaluation of oral hygiene practices for patients in the course of fixed orthodontic therapy and the identification of changes appeared at the level of the marginal periodontium caused by the orthodontic appliances.
Material and methods: A questionnaire with 20 questions was distributed to a number of 129 patients undergoing the active phase of orthodontic treatment in the Orthodontic and Dentofacial Clinic of the Medical Dental School Tîrgu Mureș or in some private practices in the Bucharest metropolitan area.
Results: The majority of patients surveyed are aware of the means of dental hygiene and practice a daily brushing, associated with auxiliary means. The iatrogenic effects of the fixed therapy are represented by gingival recession, gingival overgrowth and bleeding during brushing but these were visible only in the case of a small number of patients.
Conclusions: The fixed orthodontic treatment must be started only after a thorough evaluation of the marginal periodontium, with a close orthodontist – periodontist collaboration and avoidance of jiggling-like movements.

Objectives: Fixed orthodontic appliances make daily application of oral hygiene standard procedures more difficult and in time may lead to accumulation of oral biofilms and development of gingivitis and hyperplasia. The aim of the study is to evaluate the periodontal health expressed by clinical indices in patients under orthodontic treatment with fixed appliances, according to different oral hygene maintenance programs.
Material and method: We performed a randomized prospective study on 60 patients with fixed orthodontic appliances (17-25 years of age) devided in three study groups. The clnical indices recorded were: modified gingival index, plaque index and sulcular bleeding index. Statistical analysis or the results were carried out using Student t test.
Results: The patients were randomly divided into three groups: group A-patients were instructed to use electric brush, water flosser and interdental brush, group B- electric brush, interdental brush and fluoride and group C- manual brushing and fluoride. Statistical comparison of the values of the indexes with the Student t test for independent samples showed statistically significant differences in all three groups of patients studied between initial and final values of all recorded clinical parameters.
Conclusions: Fixed orthodontics do not induce periodontal disease if basic principles of oral hygiene are followed in compliant patients, which are correctly instructed to deal with real challenge, represented by complete elimination of debris and bacterial accumulation.