Analysis of the transverse dental arch dimension stability and risk of gingival recessions associated with orthodontic treatment

Abstract

Relevance. Orthodontic treatment may adversely affect the periodontal health. Therefore, a comprehensive diagnosis and treatment planning with a periodontist are crucial. Dentoalveolar expansion is one of the ways to provide the space for malocclusion correction. Nevertheless, the stability of the obtained transverse dimensions remains insufficiently studied and requires additional research.Material and methods. The comparative study included the clinical and paraclinical stages. The inclusion and exclusion criteria determined the study sample formation. Each patient had orthodontic treatment with the same standard arch-changing protocol recommended by the manufacturer; the average treatment duration was 18 ± 4 months. All patients underwent a clinical examination specifically focused on the gingival recession diagnosis. During the paraclinical stage, the study investigated medical records and measured study model parameters using Pont’s (1909) and Linder-Hart (1939) indices. Measurements were made four times during orthodontic treatment: before, immediately after, one and six years after treatment. All obtained data were statistically processed using the significance criteria.Results. Study models’ analysis during the active stage of treatment revealed expansion in each segment of the dentition. However, the result is prone to relapse within the first year after the bracket system removal. Clinical examination of the oral cavity revealed gingival recessions, which appeared during the active stage of the orthodontic treatment. Thus, every third case showed marginal tissue displacement. The comparison of the initial transverse dimensions in the study and control groups detected a discrepancy between the measured and reference values, which might be a prerequisite for determining new parameters.Conclusion. A periodontist should monitor orthodontic patients to protect periodontal health. The transverse dimensions appeared to increase to the utmost in the upper and lower premolar regions. However, the achieved result does not always remain stable. Most relapses occur during the first year after the orthodontic treatment; then, the outcome remains stable.