IAJPS 2018, 05 (10), 10079-10082 Khakimova Dinara et al ISSN 2349-7750

CODEN [USA]: IAJPBB ISSN: 2349-7750

INDO AMERICAN JOURNAL OF

PHARMACEUTICAL SCIENCES

Available online at: http://www.iajps.com Review Article

ORAL HYGIENE AND GINGIVAL STATUS IN ORTHODONTIC

PATIENTS: A SYSTEMATIC REVIEW
Professor- Admakin Oleg, Assistant-Khakimova Dinara, Assistant- Latuta Nadezhda
Department of Prevention and Communal Dentistry I.M. Sechenov First Moscow State Medical
University (Sechenov University)

Abstract:
The main aim of this study was to identify periodontal problems before orthodontic treatment, determine the correct
treatment plan to ameliorate these problems, and sequence the orthodontic and periodontal therapy correctly to
enhance the patient's periodontal health. This article describes the responsibilities of orthodontists for diagnosing
periodontal problems and discusses the interdisciplinary management of several periodontal problems requiring
orthodontic intervention. The aim of this article is to review oral care products to maintain oral health during
orthodontic treatment.
The proper selection of hygiene products is one of the most important questions. Nowadays, the amount of hygiene
products is extremely large. Annually, dental companies present new products of oral hygiene. The main tool for
removing plaque is a toothbrush. Manual, electric, ultrasonic brushes allow cleaning even «hard-to-reach» tooth
surfaces. Fabricant E.G. [15] found that the use of a toothbrush with the small working part (width of 10 mm and a
length of 22 mm) allows achieving the highest level of oral hygiene.
Key words: orthodontic and periodontal therapy, Floss
Corresponding author:
Khakimova Dinara, QR code
Department of Prevention and Communal Dentistry
I.M. Sechenov First Moscow State Medical University
(Sechenov University)

Please cite this article in press Khakimova Dinara et al., Oral Hygiene and Gingival Status in Orthodontic
Patients: A Systematic Review., Indo Am. J. P. Sci, 2018; 05(10).

www.iajps.com Page 10079

 IAJPS 2018, 05 (10), 10079-10082 Khakimova Dinara et al ISSN 2349-7750

INTRODUCTION: Toothbrushes
Most orthodontic patients with fixed appliances are According to Leus PA [12], the main affordable and
adolescents. . Except unusual situations, younger effective method of prevention of periodontal disease
patients generally have a healthy periodontal tissue. is regular and accurate individual oral hygiene, the
Some uncooperative patients may develop gingival purpose of which should be the maximum
inflammation, though the majority of children and mechanical removal of dental plaque and prevention
adolescents do not experience alveolar bone loss of formation of dental calculus.
during orthodontics, because of сurrently,
orthodontists are treating more adult patients. The The aim of this article is to review oral care products
percentage of adults in some orthodontic offices is to maintain oral health during orthodontic treatment.
more than 40%. Many of these patients have The proper selection of hygiene products is one of the
underlying periodontal problems that could become most important questions. Nowadays, the amount of
worse during orthodontic therapy. It is important for hygiene products is extremely large. Annually, dental
orthodontists to identify periodontal problems before companies present new products of oral hygiene. The
orthodontic treatment, determine the correct main tool for removing plaque is a toothbrush.
treatment plan to ameliorate these problems, and Manual, electric, ultrasonic brushes allow cleaning
sequence the orthodontic and periodontal therapy even «hard-to-reach» tooth surfaces. Fabricant E.G.
correctly to enhance the patient's periodontal health. [15] found that the use of a toothbrush with the small
This article describes the responsibilities of working part (width of 10 mm and a length of 22
orthodontists for diagnosing periodontal problems mm) allows to achieve the highest level of oral
and discusses the interdisciplinary management of hygiene.
several periodontal problems requiring orthodontic
intervention. Ulitovsky SB., Smirnov S.S.[13], Ulitovsky SB.,
Kalinina OI[11]reported a higher cleaning efficiency
As malocclusion has been shown to affect of the electric toothbrush compared to manual.
periodontal health[1] and so one of the objectives of Regarding to this, the use of electric toothbrush leads
orthodontic treatment is to promote better dental to decrease of inflammation in periodontal tissues in
health. Treatment contributes to better oral hygiene comparison to brushing teeth with a manual
by correcting dental irregularities and reduces (or toothbrush. [10]
eliminates) occlusal trauma. Due to these reasons, it
seems that orthodontic treatment improves According to Bazan SV.[14], the use of an ultrasonic
periodontal status as straighter teeth are easier to toothbrush "Ultrasonex" reduces gingival bleeding up
clean, and perhaps having all teeth in right position a to 60% and reduces the degree of inflammation of the
healthier periodontium.[2] gums up to 28%. Stanford CM. et al. [16] said
ultrasonic toothbrush capable to remove more than
The effects following the insertion of orthodontic 70% of plaque when the bristles are located at 2-3
appliances on the tooth’s surfaces can contribute to mm from the sample surface. This type of brushes
chronic infection, inflammatory hyperplasia, remove plaque from the visible surfaces of teeth up to
irreversible loss of attachment (permanent bone loss), 40% more efficiently and cleans approximal surfaces
and gingival recession. Although an association 82% better than a manual brush, that reverse
between orthodontic tooth movement and gingival gingivitis (Kugel G., Boghosian AA,)[17]. The use of
recession has been mentioned in both the orthodontic an ultrasonic toothbrush is particularly effective in
and the periodontal literature, many of these studies patients with dental implants and bracket systems
are relevant to mandibular incisor teeth. Some (Costa M.R. et al, ).[18]
investigators have shown gingival recession to be
associated with labial movement of the mandibular Floss
incisors and have therefore considered this movement The effectiveness of the prevention of periodontal
as a risk factor for gingival recession,[6,7] while disease significantly increases by using of interdental
others have found no such association between hygiene. According to Polyanskaya L.N. [19], the use
orthodontic tooth movement and gingival of dental floss reduced gum inflammation in the area
recession.[8,9,] Moreover, it is argued that of the contact surfaces of teeth by 28.3%.
preexisting mucogingival problems can be Rational oral hygiene using a toothbrush and
exacerbated with orthodontic force application.[6,9] toothpaste is an integral part of oral hygiene,
Materials and methods however, in the treatment of non-removable

www.iajps.com Page 10080

 IAJPS 2018, 05 (10), 10079-10082 Khakimova Dinara et al ISSN 2349-7750

Orthodontic appliances using only mechanical highest possible level and this has to be maintained
methods, it is often not always possible to remove the during the treatment.
plaque and the microorganisms contained in it
completely. As an available method of improving the The intensity and prevalence of inflammation in
hygienic condition of the oral cavity, along with the periodontal tissues in patients with fixed braces is
mechanical removal of dental plaque, solutions for quite high. Literary data indicates a variety of
rinsing the oral cavity are widely used. methods in prevention and local treatment of
inflammatory periodontal diseases, affecting different
Mouthwash parts of their pathogenesis. However, the problem of
Mouth rinses are considered as an addition to the preventive dentistry is to control the formation of
mechanical cleaning of the oral cavity from plaque. plaque - the main etiological factor of the
The rinse has a liquid consistency, which allows it to development of inflammation in periodontal tissue-
easily penetrate into hard-to-reach surfaces of the oral via designing restrict recommendations which of oral
cavity. hygiene products to use.

It has been established that oral rinses increase the REFERENCES:

efficiency of dental plaque removal, have an 1. Shivakumar K, Chandu G, Sha ulla M. Severity
antiseptic and anti-inflammatory effect. At the of malocclusion and orthodontic treatment needs
moment, a variety of mouth rinses is very large. among 12-to 15-year-old school children of
Davangere District, Karnataka, India. Eur J Dent
The mouthwash should perform a variety of 2010;4:298-307.
functions: improve the cleaning of tooth surfaces, 2. Bollen AM, Cunha-Cruz J, Bakko DW, Huang
prevent the formation of plaque, deodorize the oral GJ, Hujoel PP. The effects of orthodontic
cavity, have a pleasant, non-irritating taste, be safe to therapy on periodontal health: A systematic
use, contain active ingredients that contribute to the review of controlled evidence. J Am Dent Assoc
prevention and treatment of hard dental tissues and 2008;139:413-22.
periodontal tissues . 3. Zachrisson S, Zachrisson BU. Gingival condition
In clinical practice, as a prophylaxis and treatment of associated with orthodontic treatment. Angle
inflammatory diseases of periodontal tissues, Orthod 1972;42:26-34.
antiseptic rinses are used in the treatment of dental 4. Boyd RL. Longitudinal evaluation of a system for
anomalies with fixed orthodontic appliances. The self-monitoring plaque control effectiveness in
active components of antiseptic solutions are orthodontic patients. J Clin Periodontol
chlorhexidine, triclosan, phenolic essential oils, and 1983;10:380-8.
cetylpyridine chloride. 5. Willmot D. Orthodontic treatment and the
compromised periodontal patient. Eur J Dent
Virtually all available conditioners used for the 2008;2:1-2
prevention and treatment of inflammatory diseases of 6. Melsen B, Allais D. Factors of importance for the
periodontal tissues contain alcohols or active development of dehiscences during labial
ingredients, the use of which is limited in time, the movement of mandibular incisors: A
accidental ingestion of which is strictly retrospective study of adult orthodontic patients.
contraindicated. These aspects lead researchers to Am J Orthod Dentofacial Orthop 2005;127:552-
search for new mouthwash that will have no 61
contraindications to use and time use restrictions. 7. Djeu G, Hayes C, Zawaideh S. Correlation
between mandibular central incisor proclination
A good way is mouthwash based on natural and gingival recession during fixed appliance
ingredients. This type of mouth rinse aids can be used therapy. Angle Orthod 2002;72:238-45
by children, pregnant women and diabetics and good 8. Sallum EJ, Nouer DF, Klein MI, Gonçalves RB,
alternative for patients with fixed orthodontic Machion L, Wilson Sallum A, et al. Clinical and
appliances, as they can be used continuously microbiologic changes after removal of
throughout the entire orthodontic treatment. orthodontic appliances. Am J Orthod Dentofacial
Orthop 2004;126:363-6.
CONCLUSIONS: 9. Joss-Vassalli I, Grebenstein C, Topouzelis N,
Average visible plaque and inflammation values Sculean A, Katsaros C. Orthodontic therapy and
increase during orthodontic treatment. Therefore, gingival recession: A systematic review. Orthod
before receiving orthodontic treatment, Craniofac Res 2010;13:127-41.
the periodontal health of the patient should be the 10. Ulitovskii S. B. Applied oral hygiene // New in

www.iajps.com Page 10081

 IAJPS 2018, 05 (10), 10079-10082 Khakimova Dinara et al ISSN 2349-7750

dentistries. - 2000. - № 6 (86). - 128 p.

11. Kalinin V. N., Savelieva N. A., Shvets E. N. Prior
the results of the implementation of a
comprehensive system of caries prevention in
children 7-8 years of Ryazan: Proceedings of the
5th Congress of Dental association of Russia. -
M., 2006. — Pp. 50-51.
12. Leus P. A. Clinical and experimental study of the
pathogenesis, pathogenetic conservative therapy
and caries prevention teeth: autoref. dis. ... Dr.
med. sciences'. - M., 2006. - 30
13. Ulitovskii S. B. Hygiene of the oral cavity as the
leading part prevention and reduction of the
prevalence of dental diseases / / New in
dentistry. - 2004. - № 7. - P.129-133.
14. Bazan, S. V. Comparative assessment of the
impact of ultrasonic vibrations on the restoration
of the structure when carrying out professional
hygiene of the oral cavity (experimentally-
clinical research) [Text]: author. dis. ... kand.
honey. Sciences / Bazan Svetlana Vitalievna.
⎯M., 2002. ⎯ 19 p.
15. Fabrikant, E. G., Smirnyagina V. V., Gurevich K.
G. The Dynamics Of changes in the quality of
life in the treatment of chronic generalized
periodontitis / / Institute of dentistry. 2008. No.
4. – Pp. 78-79
16 Stanford CM , Srikantha R , Wu CD Efficacy of
the Sonicare toothbrush fluid dynamic action on
removal of human supragingival plaque.. The
Journal of Clinical Dentistry [01 Jan 1997, 8(1
Spec No):10-14]
17 Kugel G , Boghosian AA Impact of the sonicare
toothbrush on plaque and gingivitis.
Compendium of Continuing Education in
Dentistry (Jamesburg, N.J. : 2002) [01 Jul 2002,
23(7 Suppl 1):7-10]
18. Efficacy of Ultrasonic, Electric and Manual
Toothbrushes in Patients with Fixed Orthodontic
Appliances Mauricio Ribeiro Costaa; Vanessa
Camila Silvab, Angle Orthodontist, Vol 77, No
2, 2007
19. Polyanskaya, L. N. Prevention of inflammatory
diseasesperiodontium using mechanical hygiene
products: Dis. - SMO Minsk, 2005.

www.iajps.com Page 10082