Association between Gingival Phenotype and Periodontal Disease Severity—A Comparative Longitudinal Study among Patients Undergoing Fixed Orthodontic Therapy and Invisalign Treatment
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethical Approval
2.2. Study Sample
2.3. Eligibility Criteria
2.4. Clinical Parameters
2.5. Procedure
2.6. Oral Hygiene Instruction
2.7. Gingival Biotype Assessment
2.8. Statistical Analysis
3. Results
3.1. Demographic Characteristics
3.2. Oral Hygiene Practices among the Participants
3.3. Comparison of Clinical Periodontal Parameters at Baseline and 6 Months among the Groups
3.3.1. Transgingival Probing (mm) and Keratinized Tissue Width (KTW) at Baseline
3.3.2. Full Mouth Plaque Score (FMPS) at Baseline and Six Months
3.3.3. Gingival Index at Baseline and Six Months
3.3.4. Full Mouth Bleeding Score (FMBS) at Baseline and Six Months
3.3.5. Probing Depth (PD) at Baseline and Six Months
3.3.6. Clinical Attachment Level (CAL) at Baseline and Six Months
3.3.7. Gingival Recession (GR) at Baseline and Six Months
3.4. Post Hoc Bonferroni Comparison among the Groups
3.5. Comparison of Periodontal Changes among Thick and Thin Phenotype
3.5.1. Thick Phenotype
3.5.2. Thin Phenotype
4. Discussion
Strengths and Limitations of This Study
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Groups | Total | p-Value | |||||
---|---|---|---|---|---|---|---|
Invisalign | FOT | Control | |||||
Age | n | 30 | 30 | 30 | 90 | ||
Mean ± SD | 23.67 ± 3.58 | 22.37 ± 4.44 | 23.97 ± 4.49 | 23.33 ± 4.21 | 0.296 ns | ||
95% CI for mean | 22.33–25.01 | 20.71–24.03 | 22.29 ± 25.64 | 22.45 ± 24.21 | |||
Gender | Male | Frequency | 18 | 11 | 13 | 42 | 0.175 ns |
% | 42.9% | 26.2% | 31.0% | 100.0% | |||
Female | Frequency | 12 | 19 | 17 | 48 | ||
% | 25.0% | 39.6% | 35.4% | 100.0% | |||
Place of stay | Rural | Frequency | 6 | 15 | 14 | 35 | 0.033 * |
% | 17.1% | 42.9% | 40.0% | 100.0% | |||
Urban | Frequency | 24 | 15 | 16 | 55 | ||
% | 43.6% | 27.3% | 29.1% | 100.0% | |||
Total | Frequency | 30 | 30 | 30 | 90 | ||
% | 33.3% | 33.3% | 33.3% | 100.0% |
Group | Total | p-Value | |||||
---|---|---|---|---|---|---|---|
Invisalign | FOT | Control | |||||
Q1. How many times do you brush your teeth brush your teeth? | Once a day | Frequency | 3 | 2 | 9 | 14 | 0.029 * |
% | 21.4% | 14.3% | 64.3% | 100.0% | |||
Twice a day | Frequency | 18 | 20 | 19 | 57 | ||
% | 31.6% | 35.1% | 33.3% | 100.0% | |||
More than two times a day | Frequency | 9 | 8 | 2 | 19 | ||
% | 47.4% | 42.1% | 10.5% | 100.0% | |||
Q2. How do you clean your teeth? | Toothbrush, fluoride toothpaste, and dental floss | Frequency | 5 | 0 | 14 | 19 | 0.001 ** |
% | 26.3% | 0.0% | 73.7% | 100.0% | |||
Toothbrush, fluoride toothpaste | Frequency | 25 | 30 | 16 | 71 | ||
% | 35.2% | 42.3% | 22.5% | 100.0% | |||
Q3. How often do you change your toothbrush | Once in 3 months | Frequency | 16 | 5 | 6 | 27 | 0.001 ** |
% | 59.3% | 18.5% | 22.2% | 100.0% | |||
Once in 6 months | Frequency | 13 | 23 | 14 | 50 | ||
% | 26.0% | 46.0% | 28.0% | 100.0% | |||
After 1 year | Frequency | 1 | 2 | 10 | 13 | ||
% | 7.7% | 15.4% | 76.9% | 100.0% | |||
Q4. Do you use mouthwashes containing fluoride? | Often | Frequency | 14 | 18 | 18 | 50 | 0.134 ns |
% | 28.0% | 36.0% | 36.0% | 100.0% | |||
Sometimes | Frequency | 9 | 11 | 10 | 30 | ||
% | 30.0% | 36.7% | 33.3% | 100.0% | |||
Rare/never | Frequency | 7 | 1 | 2 | 10 | ||
% | 70.0% | 10.0% | 20.0% | 100.0% | |||
Q5. Do you complain of halitosis (bad smell from your mouth)? | Often | Frequency | 14 | 6 | 9 | 29 | 0.002 ** |
% | 48.3% | 20.7% | 31.0% | 100.0% | |||
Sometimes | Frequency | 14 | 22 | 11 | 47 | ||
% | 29.8% | 46.8% | 23.4% | 100.0% | |||
Rare/never | Frequency | 2 | 2 | 10 | 14 | ||
% | 14.3% | 14.3% | 71.4% | 100.0% | |||
Q6. Do you complain of bleeding on brushing or gingival bleeding? | Often | Frequency | 16 | 15 | 8 | 39 | 0.001 ** |
% | 41.0% | 38.5% | 20.5% | 100.0% | |||
Sometimes | Frequency | 8 | 14 | 8 | 30 | ||
% | 26.7% | 46.7% | 26.7% | 100.0% | |||
Rare/never | Frequency | 6 | 1 | 14 | 21 | ||
% | 28.6% | 4.8% | 66.7% | 100.0% | |||
Q7. How often do you get your teeth cleaned by a dentist? | Rare/never | Frequency | 5 | 3 | 25 | 33 | 0.001 ** |
% | 15.2% | 9.1% | 75.8% | 100.0% | |||
Once in a year | Frequency | 16 | 11 | 5 | 32 | ||
% | 50.0% | 34.4% | 15.6% | 100.0% | |||
Twice in a year | Frequency | 9 | 16 | 0 | 25 | ||
% | 36.0% | 64.0% | 0.0% | 100.0% | |||
Q8. Do you suffer from tooth sensitivity? | Often | Frequency | 10 | 13 | 8 | 31 | 0.352 ns |
% | 32.3% | 41.9% | 25.8% | 100.0% | |||
Sometimes | Frequency | 12 | 12 | 10 | 34 | ||
% | 35.3% | 35.3% | 29.4% | 100.0% | |||
Rare/never | Frequency | 8 | 5 | 12 | 25 | ||
% | 32.0% | 20.0% | 48.0% | 100.0% | |||
Total | Frequency | 30 | 30 | 30 | 90 | ||
% | 33.3% | 33.3% | 33.3% | 100.0% |
N | Mean | Std. Deviation | 95% Confidence Interval for Mean | p-Value | |||
---|---|---|---|---|---|---|---|
Lower Bound | Upper Bound | ||||||
Transgingival probing (mm) | Invisalign | 30 | 1.25 | 0.46 | 1.07 | 1.42 | 0.332 ns |
FOT | 30 | 1.13 | 0.63 | 0.89 | 1.37 | ||
Control | 30 | 1.06 | 0.27 | 0.96 | 1.17 | ||
Total | 90 | 1.15 | 0.48 | 1.05 | 1.25 | ||
KTW (mm) | Invisalign | 30 | 4.72 | 0.97 | 4.36 | 5.08 | 0.001 * |
FOT | 30 | 5.74 | 1.62 | 5.13 | 6.34 | ||
Control | 30 | 4.47 | 1.36 | 3.97 | 4.98 | ||
Total | 90 | 4.98 | 1.44 | 4.68 | 5.28 | ||
FMPS (baseline) | Invisalign | 30 | 14.62 | 6.89 | 12.05 | 17.20 | 0.004 * |
FOT | 30 | 10.31 | 7.52 | 7.51 | 13.12 | ||
Control | 30 | 9.61 | 3.16 | 8.43 | 10.79 | ||
Total | 90 | 11.52 | 6.49 | 10.16 | 12.87 | ||
FMPS (6 months) | Invisalign | 30 | 33.98 | 16.48 | 27.83 | 40.13 | 0.001 ** |
FOT | 30 | 22.47 | 11.52 | 18.17 | 26.77 | ||
Control | 30 | 10.87 | 3.30 | 9.64 | 12.10 | ||
Total | 90 | 22.44 | 15.01 | 19.30 | 25.58 | ||
Gingival index (baseline) | Invisalign | 30 | 0.65 | 0.28 | 0.54 | 0.75 | 0.009 * |
FOT | 30 | 0.60 | 0.27 | 0.50 | 0.70 | ||
Control | 30 | 0.90 | 0.56 | 0.69 | 1.10 | ||
Total | 90 | 0.71 | 0.41 | 0.63 | 0.80 | ||
Gingival index (6 months) | Invisalign | 30 | 1.50 | 0.56 | 1.29 | 1.72 | 0.651 ns |
FOT | 30 | 1.54 | 0.58 | 1.32 | 1.75 | ||
Control | 30 | 1.66 | 0.88 | 1.33 | 1.99 | ||
Total | 90 | 1.57 | 0.69 | 1.42 | 1.71 | ||
FMBS (baseline) | Invisalign | 30 | 12.18 | 6.68 | 9.69 | 14.67 | 0.005 * |
FOT | 30 | 8.33 | 4.02 | 6.83 | 9.83 | ||
Control | 30 | 12.82 | 5.62 | 10.72 | 14.92 | ||
Total | 90 | 11.11 | 5.83 | 9.89 | 12.33 | ||
FMBS (6 months) | Invisalign | 30 | 26.17 | 12.87 | 21.37 | 30.98 | 0.124 ns |
FOT | 30 | 22.41 | 6.42 | 20.01 | 24.80 | ||
Control | 30 | 21.09 | 9.27 | 17.63 | 24.56 | ||
Total | 90 | 23.22 | 10.01 | 21.13 | 25.32 | ||
PD (baseline) | Invisalign | 30 | 2.02 | 0.40 | 1.87 | 2.17 | 0.00 1 ** |
FOT | 30 | 1.61 | 0.51 | 1.42 | 1.80 | ||
Control | 30 | 1.37 | 0.47 | 1.19 | 1.54 | ||
Total | 90 | 1.66 | 0.53 | 1.55 | 1.78 | ||
PD (6 months) | Invisalign | 30 | 2.39 | 0.82 | 2.08 | 2.70 | 0.001 ** |
FOT | 30 | 2.54 | 0.40 | 2.39 | 2.69 | ||
Control | 30 | 1.67 | 0.51 | 1.48 | 1.86 | ||
Total | 90 | 2.20 | 0.71 | 2.05 | 2.35 | ||
CAL (baseline) | Invisalign | 30 | 1.52 | 0.76 | 1.23 | 1.80 | 0.558 ns |
FOT | 30 | 1.51 | 1.00 | 1.14 | 1.88 | ||
Control | 30 | 1.32 | 0.65 | 1.07 | 1.56 | ||
Total | 90 | 1.45 | 0.81 | 1.28 | 1.62 | ||
CAL (6 months) | Invisalign | 30 | 1.42 | 0.68 | 1.17 | 1.68 | 0.001 ** |
FOT | 30 | 2.16 | 1.44 | 1.62 | 2.69 | ||
Control | 30 | 1.24 | 0.66 | 1.00 | 1.49 | ||
Total | 90 | 1.61 | 1.06 | 1.39 | 1.83 | ||
GR (baseline) | Invisalign | 30 | 0.81 | 0.28 | 0.71 | 0.91 | 0.073 * |
FOT | 30 | 1.17 | 0.75 | 0.88 | 1.45 | ||
Control | 30 | 0.92 | 0.67 | 0.67 | 1.17 | ||
Total | 90 | 0.96 | 0.62 | 0.84 | 1.09 | ||
GR (6 months) | Invisalign | 30 | 1.31 | 0.56 | 1.10 | 1.52 | 0.001 ** |
FOT | 30 | 1.93 | 0.71 | 1.67 | 2.20 | ||
Control | 30 | 1.19 | 0.60 | 0.97 | 1.41 | ||
Total | 90 | 1.48 | 0.70 | 1.33 | 1.62 |
Dependent Variable | Mean Difference (I-J) | Std. Error | p-Value | 95% Confidence Interval | |||
---|---|---|---|---|---|---|---|
Lower Bound | Upper Bound | ||||||
KTW | Invisalign | FOT | −1.01320 * | 0.35 | 0.01 | −1.86 | −0.17 |
Control | 0.25 | 0.35 | 1.00 | −0.60 | 1.10 | ||
FOT | Control | 1.26109 * | 0.35 | 0.00 | 0.41 | 2.11 | |
FMPS (baseline) | Invisalign | FOT | 4.30856 * | 1.59 | 0.02 | 0.42 | 8.19 |
Control | 5.01247 * | 1.59 | 0.01 | 1.13 | 8.90 | ||
FOT | Control | 0.70 | 1.59 | 1.00 | −3.18 | 4.58 | |
FMPS (6 months) | Invisalign | FOT | 11.50790 * | 3.04 | 0.00 | 4.09 | 18.92 |
Control | 23.10944 * | 3.04 | 0.00 | 15.69 | 30.52 | ||
FOT | Control | 11.60153 * | 3.04 | 0.00 | 4.19 | 19.02 | |
Gingival index (baseline) | Invisalign | FOT | 0.05 | 0.10 | 1.00 | −0.20 | 0.30 |
Control | −0.24745 * | 0.10 | 0.05 | −0.49 | 0.00 | ||
FOT | Control | −0.29658 * | 0.10 | 0.01 | −0.54 | −0.05 | |
FMBS (baseline) | Invisalign | FOT | 3.84911 * | 1.43 | 0.03 | 0.35 | 7.34 |
Control | −0.64 | 1.43 | 1.00 | −4.13 | 2.86 | ||
FOT | Control | −4.48830 * | 1.43 | 0.01 | −7.98 | −0.99 | |
PD (baseline) | Invisalign | FOT | 0.41111 * | 0.12 | 0.00 | 0.12 | 0.70 |
Control | 0.65291 * | 0.12 | 0.00 | 0.36 | 0.95 | ||
FOT | Control | 0.24 | 0.12 | 0.14 | −0.05 | 0.53 | |
PD (6 months) | Invisalign | FOT | −0.15 | 0.16 | 1.00 | −0.53 | 0.23 |
Control | 0.72396 * | 0.16 | 0.00 | 0.34 | 1.11 | ||
FOT | Control | 0.87083 * | 0.16 | 0.00 | 0.49 | 1.25 | |
CAL (6 months) | Invisalign | FOT | −0.73447 * | 0.26 | 0.02 | −1.36 | −0.11 |
Control | 0.18 | 0.26 | 1.00 | −0.44 | 0.81 | ||
FOT | Control | 0.91659 * | 0.26 | 0.00 | 0.29 | 1.54 | |
GR (6 months) | Invisalign | FOT | −0.62255 * | 0.16 | 0.00 | −1.02 | −0.23 |
Control | 0.12 | 0.16 | 1.00 | −0.27 | 0.52 | ||
FOT | Control | 0.74543 * | 0.16 | 0.00 | 0.35 | 1.14 |
Mean Differences | ||||
---|---|---|---|---|
Invisalign | FOT | Control | ||
Thick phenotype | FMPS (baseline)—FMPS (6 months) | −24.8707 * | −12.3489 * | 1.00464 |
Gingival index (baseline)—Gingival index (6 months) | −0.83355 * | −1.10409 * | −0.3187 * | |
FMBS (baseline)—FMBS (6 months) | −9.10298 * | −12.6579 * | −4.65995 * | |
PD (baseline)—PD (6 months) | −1.01267 * | −1.02544 * | −0.16858 | |
CAL (baseline)—CAL (6 months) | −0.07885 | 0.01982 | 0.03432 | |
GR (baseline)—GR (6 months) | −0.37289 * | −0.49731 | −0.18168 | |
Thin phenotype | FMPS (baseline)—FMPS (6 months) | −13.8438 * | −11.9669 * | −3.52517 * |
Gingival index (baseline)—Gingival index (6 months) | −0.87969 * | −0.77284 * | −1.21405 * | |
FMBS (baseline)—FMBS (6 months) | −18.8856 * | −15.4932 * | −11.8929 * | |
PD (baseline)—PD (6 months) | 0.26836 | −0.83482 * | −0.43363 * | |
CAL (baseline)—CAL (6 months) | 0.26836 | −1.3164 * | 0.11493 | |
GR (baseline)—GR (6 months) | −0.62678 * | −1.04009 * | −0.36007 * |
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Alasiri, M.M.; Almalki, A.; Alotaibi, S.; Alshehri, A.; Alkhuraiji, A.A.; Thomas, J.T. Association between Gingival Phenotype and Periodontal Disease Severity—A Comparative Longitudinal Study among Patients Undergoing Fixed Orthodontic Therapy and Invisalign Treatment. Healthcare 2024, 12, 656. https://doi.org/10.3390/healthcare12060656
Alasiri MM, Almalki A, Alotaibi S, Alshehri A, Alkhuraiji AA, Thomas JT. Association between Gingival Phenotype and Periodontal Disease Severity—A Comparative Longitudinal Study among Patients Undergoing Fixed Orthodontic Therapy and Invisalign Treatment. Healthcare. 2024; 12(6):656. https://doi.org/10.3390/healthcare12060656
Chicago/Turabian StyleAlasiri, Mansour M., Abdullah Almalki, Saud Alotaibi, Abdullah Alshehri, Alhanouf A. Alkhuraiji, and Julie Toby Thomas. 2024. "Association between Gingival Phenotype and Periodontal Disease Severity—A Comparative Longitudinal Study among Patients Undergoing Fixed Orthodontic Therapy and Invisalign Treatment" Healthcare 12, no. 6: 656. https://doi.org/10.3390/healthcare12060656