Improvement of gingival condition in crowded dentitions during fixed orthodontic treatment

Objective:The present study examined the change of gingival condition during fixed orthodontic treatment. Methods:A total of 196 patients were followed longitudinally during fixed orthodontic treatment, consisting of 54 patients with severe crowding, 45 with moderate crowding, 44 with mild crowding and 53 with no crowding. All patients were given oral hygiene instruction. The gingival status was assessed by gingival bleeding index (GBI) at bonding, at 12, 24, and 48 weeks after bonding, and at debonding. Results:At bonding, the GBI was the same in the above 4 groups. However, the GBI scores lowered significantly from 12 weeks after bonding to debonding in the patients with severe and moderate crowded dentitions, whereas the patients with mild and no crowded dentitions showed no obvious changes. Possible reason for this difference was that the crowding gradual elimination during the first few months of treatment in severe and moderate crowded dentitions had a positive psychological effect, motivating the patients to abide by oral hygiene instruction better, according to practitioners' records. Conclusion:Although some studies showed that most patients with fixed orthodontic appliances experienced an increased incidence of gingivitis during treatment, gingival condition can be improved significantly, especially those with crowded dentitions, provided that the patients have a better oral hygiene.