Evaluation of clinical indices, microbiological and matrix metalloproteinase-8 levels in subgingival biofilm of patients with fixed appliance, before and during orthodontic treatment
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Summary
Objectives: The aim of the present prospective study was to investigate changes in clinical parameters, periodontopathogens (PP) levels and active matrix metalloproteinase-8 (aMMP-8) concentration in gingival crevicular fluid of patients before and during treatment with fixed orthodontic appliances.
Material and Methods: Fifty-five adolescents (30 females, 25 males; ages 12-17 years), who were scheduled for fixed orthodontic treatment, were selected and included in this study. Clinical parameters and subgingival samples were obtained at six time points: 1 week before appliance insertion (T0), 3 (T1), 6 (T2) weeks, 3 (T3), 6 (T4) months and 1 year after therapy begin. Gingival index (GI) and plaque index (PI) were assessed to evaluated changes on the clinical status and, subgingival samples were used to analyze changes of aMMP-8 concentration and levels of the following PP: Agreggatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Prevotella intermedia (Pi), Fusobacterium spp (Fs), Parvimonas micra (Pm) Campylobacter rectus (Cr), Eubacterium nodatum (En), Eikenella corrodens (Ec) and Capnocytophaga spp (Cs).
Results: Scores for GI and PI increased after appliance insertion. GI showed a continuous increase from T2 (p<0.05) until T5 (p<0.0001). PI increased following brackets placement reaching its maximum peak at T3 (p<0.05), 3 months after therapy begin. Moreover, a significant increase of aMMP-8 concentration (p<0.05) and frequency of Tf, Fs, Cr, Cs, and Ec was noted. For the other tested bacteria, the frequency tended to increase, but without significant differences. As well, no significant differences were found between upper and lower jaws for all parameters evaluated.
Conclusion: Orthodontic treatment with fixed appliance in adolescents favors dental plaque accumulation and may transitionally increase GI, PI, aMMP-8 concentration and, subsequently, the growth of PP leading to gingival inflammation, even 1 year after therapy began.