Aim: The present study compares the quantitative analysis of the red-complex bacteria (RCB) in patients undergoing fixed orthodontic therapy with and without plaque-induced gingival enlargement.
Materials and methods: Forty subjects undergoing orthodontic therapy were categorized into two groups: control group: 18 periodontally healthy subjects without plaque-induced gingival enlargement undergoing orthodontic treatment and study group: 22 subjects with plaque-induced gingival enlargement undergoing orthodontic treatment. Plaque index (PI), bleeding on probing (BOP %), simplified oral hygiene index (OHI-S), and probing pocket depth (PPD) were recorded. The type and frequency of tooth brushing were also assessed. Plaque samples were collected from the periodontal pockets and analyzed using real-time polymerase chain reaction (RT-PCR) for the detection of Treponema denticola (T.d), Tannerella forsythia (T.f), and Porphyromonas gingivalis (P.g), and statistical analysis was performed.
Results: PPD, PI, OHI-S, BOP, type, and frequency of tooth brushing were higher in patients with plaque-induced gingival enlargement as compared to the controls. A significant increase in the levels of T.d, T.f, and P.g was found in both the groups, however it showed a statistical insignificance difference. Overall T.d was found to be more prevalent than T.f and P.g in both the groups. On correlating the RCB with the other variables. A positive correlation was seen with T.d and the oral hygiene index scores in the controls and the presence of T.d, T.f, and P.g with BOP and PPD in the study group.
Conclusion: The expressions of RCB levels in the dental plaque of patients undergoing orthodontic treatment with and without the inflammatory enlargement were more or less the same however, T.d was found at higher levels than the other bacteria.
Clinical significance: The study shows the association of the BOP and PPD and the presence of RCB in orthodontic patients with inflammatory enlargement putting these patients at a higher risk for periodontal attachment loss.
Lamont RJ, Koo H, Hajishengallis G. The oral microbiota: dynamic communities and host interactions. Nat Rev Microbiol 2018; 16(12):745–759. DOI: 10.1038/s41579-018-0089-x
Bartold PM, Dyke TE. Periodontitis: a host-mediated disruption of microbial homeostasis. Unlearning learned concepts. Periodontol 2000 2013;62(1):203–217. DOI: 10.1111/j.1600-0757.2012.00450.x
Ren Y, Jongsma MA, Mei L, et al. Orthodontic treatment with fixed appliances and biofilm formation—a potential public health threat? Clin Oral Investig 2014;18(7):1711–1718. DOI: 10.1007/s00784-014-1240-3
Boke F, Gazioglu C, Akkaya S, et al. Relationship between orthodontic treatment and gingival health: a retrospective study. Eur J Dent 2014;8(3):373–380. DOI: 10.4103/1305-7456.137651
Hadeel Mazin BD. The effect of fixed orthodontic appliances on gingival health.
Mukherjee PM, Almas K. Orthodontic considerations for gingival health during pregnancy: a review. Int J Dent Hyg 2010;8(1):3–9. DOI: 10.1111/j.1601-5037.2009.00383.x
Ristic M, Svabic MV, Sasic M, et al. Clinical and microbiological effects of fixed orthodontic appliances on periodontal tissues in adolescents. Orthod Craniofac Res 2007;10(4):187–195. DOI: 10.1111/j.1601-6343.2007.00396.x
Diamanti-Kipioti A, Gusberti FA, Lang NP. Clinical and microbiological effects of fixed orthodontic appliances. J Clin Periodontol 1987;14(6):326–333. DOI: 10.1111/j.1600-051x.1987.tb00979.x
Löe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38(6):610–616. DOI: 10.1902/jop. 1918.104.22.1680
Greene JC, Vermillion JR. The oral hygiene index: a method for classifying oral hygiene status. J Am Dent Assoc 1960;61(2):172–179. DOI: 10.14219/jada.archive.1960.0177
Brzezinska-Blaszczyk E, Pawlowska E, Ploszaj T, et al. Presence of archaea and selected bacteria in infected root canal systems. Can J Microbiol 2018;64(5):317–326. DOI: 10.1139/cjm-2017-0531
Kornhaber R, Walsh K, Duff J, et al. Enhancing adult therapeutic interpersonal relationships in the acute health care setting: an integrative review. J Multidiscip Healthc 2016;9:537. DOI: 10.2147/JMDH.S116957
Sunetha M, Alla E, Potdar S, et al. Malocclusion and deleterious oral habits in south indian adolescent population: a correlation study. Eur J Mol Clin Med 2020;7(7):6552–6557.
Lombardo G, Vena F, Negri P, et al. Worldwide prevalence of malocclusion in the different stages of dentition: a systematic review and meta-analysis. Eur J Paediatr Dent 2020;21(2):115–122. DOI: 10.23804/ejpd.2020.21.02.05
Hägg U, Kaveewatcharanont P, Samaranayake YH, et al. The effect of fixed orthodontic appliances on the oral carriage of Candida species and Enterobacteriaceae. Eur J Orthod 2004;26(6):623–629. DOI: 10.1093/ejo/26.6.623
Contaldo M, Lucchese A, Lajolo C, et al. The oral microbiota changes in orthodontic patients and effects on oral health: an overview. J Clin Med 2021;10(4):780. DOI: 10.3390/jcm10040780
Talic NF. Adverse effects of orthodontic treatment: a clinical perspective. Saudi Dent J 2011;23(2):55–59. DOI: 10.1016/j.sdentj. 2011.01.003
Kossack C, Jost-Brinkmann PG. Plaque and gingivitis reduction in patients undergoing orthodontic treatment with fixed appliances—comparison of toothbrushes and interdental cleaning aids. A 6-month clinical single-blind trial. J Orofac Orthop 2005;66(1):20–38. DOI: 10.1007/s00056-005-0344-4
Alfuriji S, Alhazmi N, Alhamlan N, et al. The effect of orthodontic therapy on periodontal health: a review of the literature. Int J Dent 2014;2014:585048. DOI: 10.1155/2014/585048
Sukhia HR, Ayub M, Ghandhi D. Enamel decalcification in orthodontic patients; prevalence and oral distribution–a cross sectional study. Pak Oral Dent J 2008;28(2):193–197. Corpus ID: 47609188.
Huser MC, Baehni PC, Lang R. Effects of orthodontic bands on microbiologic and clinical parameters. Am J Orthod Dentofacial Orthop 1990;97(3):213–218. DOI: 10.1016/S0889-5406(05)80054-X
Alexander SA. Effects of orthodontic attachments on the gingival health of permanent second molars. Am J Orthod Dentofacial Orthop 1991;100(4):337–340. DOI: 10.1016/0889-5406(91)70071-4
Boyd RL, Baumrind S. Periodontal considerations in the use of bonds or bands on molars in adolescents and adults. Angle Orthod 1992;62(2):117–126. DOI: 10.1043/0003-3219(1992)062<0117:PCITUO>2.0.CO;2
Sköld-Larsson K, Yucel-Lindberg T, Twetman S, et al. Effect of a triclosan-containing dental gel on the levels of prostaglandin I2 and interleukin-1 β in gingival crevicular fluid from adolescents with fixed orthodontic appliances. Acta Odontol Scand 2003;61(4):193–196. DOI: 10.1080/00016350310003242
Sallum EJ, Nouer DF, Klein MI, et al. Clinical and microbiologic changes after removal of orthodontic appliances. Am J Orthod Dentofacial Orthop 2004;126(3):363–366. DOI: 10.1016/j.ajodo.2004.04.017
Ravi N, Geetha A, Mahendra A, et al. Evaluation of the periodontal parameters and red complex microorganisms in patients undergoing orthodontic treatment: A microbiological study. Ann Rom Soc Cell Biol 2020;24(1):317–327. https://www.annalsofrscb.ro/index.php/journal/article/view/9668
Sinclair PM, Berry CW, Bennett CL, et al. Changes in gingiva and gingival flora with bonding and banding. Angle Orthod 1987;57(4):271–278. DOI: 10.1043/0003-3219(1987)057<0271:CIGAGF>2.0.CO;2
Zachrisson BU, Alnaes L. Periodontal condition in orthodontically treated and untreated individuals I. Loss of attachment, gingival pocket depth and clinical crown height. Angle Orthod 1973;43(4):402–411. DOI: 10.1043/0003-3219(1973)043<0402: PCIOTA>2.0.CO;2
Alstad S, Zachrisson BU. Longitudinal study of periodontal condition associated with orthodontic treatment in adolescents. Am J Orthod 1979;76(3):277–286. DOI: 10.1016/0002-9416(79)90024-1
Page RC, Offenbacher S, Schroeder HE, et al. Advances in the pathogenesis of periodontitis: summary of developments, clinical implications and future directions. Periodontol 2000 1997;14(1):216–248. DOI: 10.1111/j.1600-0757.1997.tb00199.x
Atassi F, Awartani F. Oral hygiene status among orthodontic patients. J Contemp Dent Pract 2010;11(4):25–32. http://www.thejcdp.com/journal/view/volume11-issue4-atassi
Ajayi EO, Azodo CC. Oral hygiene status among orthodontic patients attending University of Benin teaching hospital, Benin city, Nigeria. J Dent Health Oral Disord Ther 2014;1(4):1–4. DOI: 10.15406/jdhodt.2014.01.00023
Onyeaso CO, Arowojolu MO, Taiwo JO. Periodontal status of orthodontic patients and the relationship between dental aesthetic index and community periodontal index of treatment need. Am J Orthod Dentofacial Orthop 2003;124(6):714–20. DOI: 10.1016/j.ajodo. 2003.01.002
Hobson RS, Clark JD. How UK orthodontists advise patients on oral hygiene. Br J Orthod 1998;25(1):64–66. DOI: 10.1093/ortho/25.1.64
Gomes SC, Varela CC, Veiga SL, et al. Periodontal conditions in subjects following orthodontic therapy. A preliminary study. Eur J Orthod 2007;29(5):477–481. DOI: 10.1093/ejo/cjm050
Pinto AS, Alves LS, Zenkner JE, et al. Gingival enlargement in orthodontic patients: effect of treatment duration. Am J Orthod Dentofacial Orthop 2017;152(4):477–482. DOI: 10.1016/j.ajodo.2016.10.042
Williams P, Fenwick A, Schou L, et al. A clinical trial of an orthodontic toothbrush. Eur J Orthod 1987;9(1):295–304. DOI: 10.1093/ejo/9.4.295
Kiliçoğlu H, Yildirim M, Polater H. Comparison of the effectiveness of two types of toothbrushes on the oral hygiene of patients undergoing orthodontic treatment with fixed appliances. Am J Orthod Dentofacial Orthop 1997;111(6):591–594. DOI: 10.1016/s0889-5406(97)70309-3
Memon AB, Jabbar A, Shaikh IA, et al. Plaque score during orthodontic treatment in relation to age and gender. J Pak Dent Assoc 2015;24(2):100.
Kim SH, Choi DS, Jang I, et al. Microbiologic changes in subgingival plaque before and during the early period of orthodontic treatment. Angle Orthod 2012;82(2):254–260. DOI: 10.2319/030311-156.1
Gong YM, Cao LF, Yang Y, et al. Relationship of putative periodontopathogenic bacteria and drug-induced gingival overgrowth. Zhonghua Kou Qiang Yi Xue Za Zhi 2008;43(6):347–351. PMID: 19031785.
Ireland AJ, Soro V, Sprague SV, et al. The effects of different orthodontic appliances upon microbial communities. Orthod Craniofac Res 2014;17(2):115–123. DOI: 10.1111/ocr.12037
Liu Y, Zhang Y, Wang L, et al. Prevalence of Porphyromonas gingivalis four rag locus genotypes in patients of orthodontic gingivitis and periodontitis. PloS one 2013;8(4):e61028. DOI: 10.1371/journal.pone.0061028
Lee SM, Yoo SY, Kim HS, et al. Prevalence of putative periodontopathogens in subgingival dental plaques from gingivitis lesions in Korean orthodontic patients. J Microbiol 2005;43(3):260–265. PMID: 15995644.
Eckley B, Thomas J, Crout R, et al. Periodontal and microbiological status of patients undergoing orthodontic therapy. Hong Kong Dent J 2012;9(1):11–20.