Periodontal and microbiological evaluation in cleft lip/palate patients undergoing orthodontic treatment: A cross-sectional study

Background

The present cross-sectional study was undertaken to evaluate the periodontal and microbiological parameters in patients with surgically repaired unilateral cleft lip and palate (UCLP) undergoing orthodontic correction in comparison to patients without any cleft or orthodontic treatment.

Methods

A total of 120 patients, out of initial 148 patients, between the age group 6 and 18 years were enrolled and divided into four groups with 30 patients each: non-cleft patients without orthodontic treatment in Group 1, non-cleft patients undergoing fixed orthodontic treatment in Group 2, patients with UCLP without any orthodontic treatment in Group 3, and patients with UCLP undergoing fixed orthodontic treatment in Group 4. Periodontal parameters including plaque index (PI), gingival index (GI), gingival bleeding index (GBI), community periodontal index of treatment needs (CPITN) index, pocket probing depth (PD), and tooth mobility were measured in all the groups. The subgingival plaque samples of all the patients were subjected to microbial evaluation using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS) for clinical diagnosis.

Results

The periodontal parameters were significantly raised in Group 4, followed by Group 3 and Group 2 in comparison to Group 1 (p < 0.01), thereby suggesting poor periodontal health in patients with UCLP undergoing orthodontic treatment. Statistically significant differences (p < 0.01) in counts of micro-organisms among the groups were observed for P. gingivalis, P. intermedia, Veillonella, and Capnocytophaga, with the highest proportions in Group 4, indicating a deteriorating oral health in these patients.

Conclusion

Poor periodontal and microbial health in patients with UCLP undergoing orthodontic treatment indicates a need for reinforcement of oral hygiene practices among these patients.

Plain Language Summary

Patients with clefts of lip extending to the palate are prone to a number of oral health issues and often undergo treatment with fixed braces for teeth alignment. This may compromise the oral hygiene practice and alter the microbial flora of the oral cavity. The present study evaluated the oral health and microbial flora in patients with cleft lip and palate undergoing treatment with fixed braces in comparison to patients without any cleft or any treatment for teeth alignment. A total of 120 patients were divided into four groups. Group 1 had normal healthy individuals without any cleft or treatment for teeth alignment; Group 2 had individuals without any cleft but undergoing treatment with fixed braces for teeth alignment; Group 3 had patients with cleft lip and palate but no treatment for teeth alignment, whereas the patients undergoing treatment with fixed braces were included in Group 4. All the groups were checked for indices assessing the oral health, and microbial evaluation was also done. Patients with cleft lip and palate undergoing treatment with fixed braces were found to have poor oral health along with elevated microbial counts, signifying a need for improving oral hygiene practices in these patients.