Gingival hypertrophy seen in perspective of typology and treatment trends, at patients treated with fixed orthodontic appliances

Abstract

Gingival hypertrophy, the primary etiological factor, is the presence of bacterial plaque in the gingival sulcus, but if a fixed orthodontic appliance is placed in the affected teeth, the difficulty in achieving oral hygiene for these teeth increases, and it can even lead to "neglect" on the part of the patient. The clinical situation increases even more the possibility of gingival hypertrophy appearing. The combination of the keywords gingival hypertophy, fixed orthodontic appliance, treatment, vertical index, horizontal index and bacterial plaque in Pubmed, applying them in combination between them, brought out about 31 articles for further analysis. From the selected articles, a total of 31 articles, after reading the abstracts of the full content of the article, 7 of them were outside the topic or scope of our study. 23 articles were used for further data processing.The tendency to find the incidence or prevalence of gingival hypertrophies in cases with orthodontic appliances is almost equal in the values of 29% and 24%. The lowest ratio is in the cases of case-report studies, which reaches the level of 5%. The reduction of gingival hypertrophy is indicated by the application of 40% chlorhexidine in gel form on the vestibular surface of already affected teeth, in the area of the maxillary molars on the vestibular surface. Most of the articles try to find the cause of gingival hypertrophy to clinically compare patients without orthodontic appliances versus patients with orthodontic appliances, selecting patient samples with similarities in individual data conditions such as age for example. But seeing this trend, adolescent patients are selected more often, knowing also the close relationship that hormonal changes have with the appearance of gingival hypertrophies. This element can also lead to incorrect facts and figures. The patient's periodontal status and his age are two other factors that attract the attention of studies at almost the same level of interest, leaving other factors such as the duration of orthodontic treatment and the socio-economic status of the patient at a lower level. Oral hygiene has an impact on the appearance of gingival hypertrophy in teeth with orthodontic appliances, this is expressed more in the area of the mandibular incisors than in the mandibular molars.