Association between gingivitis and anterior gingival
               enlargement in subjects undergoing fixed orthodontic treatment

Zanatta, Fabricio Batistin; Ardenghi, Thiago Machado; Antoniazzi, Raquel Pippi; Pinto, Tatiana Militz Perrone; Rösing, Cassiano Kuchenbecker

doi:10.1590/2176-9451.19.3.059-066.oar

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Articles • Dental Press J. Orthod. 19 (3) • May-Jun 2014 • https://doi.org/10.1590/2176-9451.19.3.059-066.oar copy

Association between gingivitis and anterior gingival enlargement in subjects undergoing fixed orthodontic treatment

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

The aim of this study was to investigate the association among gingival enlargement (GE), periodontal conditions and socio-demographic characteristics in subjects undergoing fixed orthodontic treatment.

METHODS:

A sample of 330 patients undergoing fixed orthodontic treatment for at least 6 months were examined by a single calibrated examiner for plaque and gingival indexes, probing pocket depth, clinical attachment loss and gingival enlargement. Socio-economic background, orthodontic treatment duration and use of dental floss were assessed by oral interviews. Associations were assessed by means of unadjusted and adjusted Poisson's regression models.

RESULTS:

The presence of gingival bleeding (RR 1.01; 95% CI 1.00-1.01) and excess resin around brackets (RR 1.02; 95% CI 1.02-1.03) were associated with an increase in GE. No associations were found between socio-demographic characteristics and GE.

CONCLUSION:

Proximal anterior gingival bleeding and excess resin around brackets are associated with higher levels of anterior gingival enlargement in subjects under orthodontic treatment.

Epidemiology; Orthodontics; Gingivitis; Gingival enlargement

Variables	n (%)
Demographic characteristics
Sex
Male	159 (48.1%)
Female	171 (51.8%)
Ethnicity
White	263 (79.7%)
Non-White	67 (20.3%)
Age (years)
14 - 19	162 (49.0%)
20 - 24	121 (36.6%)
25 - 30	47 (14.2%)
*Socioeconomic status*
Household Income
≤ 5	270 (81.8%)
> 5	60 (18.1%)
Educational level
> 11 years	159 (48.1%)
≤ 11 years	171 (51.8%)
*Clinical status*
TUFOT (Months)
6 - 12	185 (56.06%)
> 12	145 (43.93%)
Dental floss
Users	81 (24.5%)
Non-users	249 (75.5%)

Variables	N (%)	GE0 (%)	GE1 (%)	GE2 (%)	GE3 (%)
Variables	N (%)	Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD
Demographic characteristics
Sex		p* = 0.010	p* = 0.010	p* = 0.120	p* < 0.001
Male	159 (48.1%)	58.10 ± 9.24	27.56 ± 4.55	12.52 ± 8.95	1.21 ± 3.43
Female	171 (51.8%)	58.15 ± 9.66	29.05 ± 5.53	10.48 ± 8.20	1.70 ± 2.67
Ethnics (%)		p* < 0.001	p* = 0.016	p* = 0.001	p* = 0.000
White	263 (79.7%)	59.17 ± 10.0	28.05 ± 5.04	11.17 ± 9.35	1.10 ± 3.19
Non-white	67 (20.3%)	54.04 ± 5.01	29.16 ± 5.23	13.0 ± 4.72	2.80 ± 2.21
Age (yrs)		p** = 0.037	p** < 0.001	p** < 0.001	p** = 0.083
14 - 19	162 (49.0%)	56.98 ± 10.15	27.59 ± 4.86	12.89 ± 9.19	1.88 ± 3.74
20 - 24	121 (36.6%)	59.88 ± 9.36	29.52 ± 5.30	8.91 ± 7.66	1.05 ± 2.51
24 - 30	47 (14.2%)	57.57 ± 5.79	27.46 ± 4.82	13.63 ± 7.51	0.95 ± 1.25
Socioeconomic status
Household income (Wages)		p* < 0.001	p* < 0.001	p* < 0.001	p* < 0.001
≤ 5	270 (81.8%)	56.62 ± 8.72	27.55 ± 4.39	13.35 ± 8.25	1.77 ± 3.33
> 5	60 (18.1%)	64.88 ± 9.61	31.56 ± 6.60	3.36 ± 4.81	0.0 ± 0.0
Subject’s education		p* = 0.055	p* < 0.001	p* = 0.011	p* < 0.001
≤ 11 years	159 (48.1%)	57.28 ± 9.91	27.51 ± 4.73	13.03 ± 9.11	1.46 ± 3.63
> 11 years	171 (51.8%)	59.41 ± 8.54	29.45 ± 5.41	9.28 ± 7.35	1.42 ± 2.03
Clinical status
Dental floss users		p* = 0.018	p* < 0.001	p* < 0.001	p* = 0.031
Yes	81 (24.5%)	61.46 ± 8.28	31.25 ± 5.64	6.44 ± 6.66	0.45 ± 0.90
No	249 (75.5%)	57.04 ± 9.54	27.31 ± 4.51	13.2 ± 8.57	1.77 ± 3.46
TUFOT (Months)		p*<0.001	p*<0.001	p*<0.001	p*=0.016
6 a 12	185 (56.06%)	60.56 ± 6.40	29.26 ± 3.77	8.78 ± 3.66	0.81 ± 1.69
> 12	145 (43.93%)	55.02 ± 11.56	27.02 ± 6.18	15.02 ± 11.46	2.26 ± 4.13

Variables	n (%)	AGE	AGE	AGE
Variables	n (%)	Mean ± SD	RR (95%IC)	RR* (95% IC)
Demographic characteristics
Sex			p = 0,142	**
Male	159 (48.1%)	0.72 ± 0.33	1.08 (0.97-1.20)
Female	171 (51.8%)	0.66 ± 0.34	1
Ethnics (%)			0.188	**
White	263 (79.7%)	0.7 ± 0.34	1
Non-white	67 (20.3%)	0.64 ± 0.32	0.91 (0.79-1.04)
Age (yrs)			p = 0.123	**
14-19	162 (49.0%)	0.73 ± 0.35	1.11 (0.96-1.29)
20-24	121 (36.6%)	0.66 ± 0.34	1.00 (0.85-1.17)
24-30	47 (14.2%)	0.65 ± 0.29	1
Socioeconomic status
Household income (Wages)			p = 0.213	**
≤ 5	270 (81.8%)	0.70 ± 0.33	1.10 (0.94-1.28)
> 5	60 (18.1%)	0.64 ± 0.35	1
Subject’s education			p = 0.14	**
< 11 years	159 (48.1%)	0.73 ± 0.35	1.08 (0.97 – 1.20)
≥ 11 years	171 (51.8%)	0.63 ± 0.31	1
Clinical status
Dental floss users (%)			p = 0.000	p = 0.239
Yes	81 (24.5%)	0.58 ± 0.34	1	1
No	249 (75.5%)	0.73 ± 0.33	1.25 (1.08-1.43)	1.07 (0.95-1.22)
TUFOT (Months)			p = 0.18	**
6 a 12	185 (56.06%)	0.64 ± 0.32	1
> 12	145 (43.93%)	0.75 ± 0.35	0.91 (0.79-1.04)
PAGB (%)		-	p = 0.000	p = 0.000
			1.01(1.0 – 1.01)	1.01 (1.00-1.01)
Excessive resin (% of sites)		-	p = 0.000	p = 0.000
			1.02 (1.02-1.03)	1.02 (1.02-1.03)

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