Vol. 10 No. 2 (2018): Archives of Public Health
Oral Health

The influence of orthodontic anomalies on the occurrence of gingival inflammation

Natasa Toseska-Spasova
Department of Orthodontics, Faculty of Dental Medicine, Ss. Cyril and Methodius University Skopje, Republic of Macedonia
Ylber Balazi
Private practice: BEGODENT, Kicevo, Republic of Macedonia
Biljana Dzipunova
Department of Orthodontics, Faculty of Dental Medicine, Ss. Cyril and Methodius University Skopje, Republic of Macedonia
Elena Sozovska
Ministry of Helath, Republic of Macedonia
Katerina Toseshka-Trajkovska
Institute for Medical and Experimental Biochemistry, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, Republic of Macedonia
Zoran Spasov
Private practice: PROSTHETIC S&S, Skopje, Republic of Macedonia

Published 2018-11-12


  • dental plaque,
  • gingival inflammation,
  • orthodontic anomalies

How to Cite

Toseska-Spasova N, Balazi Y, Dzipunova B, Sozovska E, Toseshka-Trajkovska K, Spasov Z. The influence of orthodontic anomalies on the occurrence of gingival inflammation. Arch Pub Health [Internet]. 2018 Nov. 12 [cited 2023 Dec. 6];10(2):29-3. Available from: https://www.id-press.eu/aph/article/view/2241


Apart from dental plaque microbes, which are the main factors in the etiology of gingival inflammation, a local risk factor that has a major impact on clinical expression of inflammation are orthodontic anomalies because they create conditions for greater accumulation of dental plaque. The aim of this study was to evaluate the influence of orthodontic malocclusion crowding and open bite, as a local risk factor in relation to the accumulation of dental plaque, which is the primary etiological factor in the etiopathogenesis of gingival inflammation, and to determine the pathological influence of the dental plaque on the gingival tissue, by recording the index of gingival inflammation (IGI) and the index of gingival bleeding (IGB). For this purpose, 60 patients with orthodontic anomalies were observed; 30 of them with crowding and 30 with open bite. As a control group, 30 examinees were included. In all examined groups index of dental plaque (IDP), index of gingival inflammation (IGI) and index of gingival bleeding (IGB) were evaluated. The results showed a statistically significant difference in IDP, IGI and IGB values  between patients with crowding and open bite compared to examinees without orthodontic anomalies. All these obtained results point to the fact that orthodontic anomalies are a risk factor for gingival inflammation which is the introduction to periodontal disease. Education, motivation and use of appropriate mechanical and chemical means for maintenance of oral hygiene are necessary in patients with orthodontic anomalies in order to protect the already affected periodontal complex


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  1. Lovegrove JM. Dental plaque revisited: bacteria associated with periodontal disease J N Z Soc Periodontol 2004; 87:7-21.
  2. Loe H, Thielade E, Jensen SB. Experimental gingivitis in man. J Periodontol 1965; 364:177-87.
  3. Liu H, Sun J, Dong Y, Lu H, Zhou H, Hansen BF, et al. Periodontal health and relative quantity of subgingival Porphyromonas gingivalis during orthodontic treatment. Angle Orthod 2011; 81:609–15.
  4. Cullinan MP, Ford PJ, Seymour GJ. Periodontal disease and systemic health: current status. Austr Dental J 2009; 54(1):S62–S69.
  5. Popova C, Dosseva-Panova V, Panov V. Microbiology of Periodontal Diseases. A Review. Biotechnol Biotechnol Equipment 2013; 27: 3754-9.
  6. Национална стратегија за превенција на оралните заболувања кај деца од 0-14 години во Република Македонија во периодот 2008-2018. Скопје : Министерство за здравство; 2007.
  7. Estela S, Roberlene D, Renata D, Renata C, Rosenês L. Association between malpositioned teeth and periodontal disease. Dental Press J Orthod 2011; 16: 87-94.
  8. Geiger AM. Malocclusion as an etiologic factor in periodontal disease: a retrospective essay. Am J Orthod Dentofac Orthop 2001; 120:112-5.
  9. Choi SH, Kim BI, Cha JY, Hwang CJ. Impact of malocclusion and common oral diseases on oral health-related quality of life in young adults. Am J Orthod Dentofacial Orthop 2015;147:587–95.
  10. Kragt L, Dhamo B, Wolvius EB, et al. The impact of malocclusions on oral health-related quality of life in children — a systematic review and meta-analysis. Clin Oral Investig 2016; 20:1881–94.
  11. Heravi F, Farzanegan F, Tabatabaee M, Sadeghi M. Do malocclusions affect the oral health-related quality of life? Oral Health Prev Dent 2011; 9:229–33.
  12. Chen M, Feng ZC,Liu X, Li ZM,Cai B,Wang DW. Impact of malocclusion on oral health-related quality of life in young adults. Angle Ortho 2015;85:986-91.
  13. Abdulwahab B. Lower arch crowding in relation to periodontal disease. MDJ 2008;5(2):154-58
  14. Kina JR, Kina J, Kina M, et al. Open Bite Malocclusion as Potential Predisposing Risk Factor to Promote Periodontal Disease. J Orthod Endod 2016; 2:3 doi: 10.4172/2469-2980.
  15. Sierwald I, John MT, Schierz O, Jost-Brinkmann PG, Reissmann DR. Association of overjet and overbite with esthetic impairments of oral health-related quality of life. J Orofac Orthop. 2015;76:405–20.
  16. Harrel SK. Oral health begins with tooth alignment. Dimensions Dent Hygiene 2011; 9:64–71.
  17. Clijmans M, Lemiere J, Fieuws S, Willems G.Impact of self-esteem and personality traits on the association between orthodontic treatment need and oral health-related quality of life in adults seeking orthodontic treatment. Eur J Orthod 2015;37:643-50.
  18. Yildiz S, Dogan B. Self reported dental health attitudes and behaviour of dental students in Turkey. Eur J Dent 2011;5:253-9.
  19. Boke F, Gazioglu C, Akkaya S, Akkaya M. Relationship between orthodontic treatment and gingival health: A retrospective study. Eur J Dent 2014; 8:373–80.
  20. Mazin H, Ali S, Salah R. The Effect of Fixed Orthodontic Appliances on Gingival Health. IOSR-JDMS 2016;15(11): 82-88.
  21. Bollen AM, Cunha-Cruz J, Bakko DW, Huang GJ, Hujoel PP.The effects of orthodontic therapy on periodontal health: a systematic review of controlled evidence. J Am Dent Assoc. 2008; 139:413-22.
  22. Li Guo, Ying Feng, Hong-Gang Guo, Bo-Wen Liu, Yang Zhang. Consequences of orthodontic treatment in malocclusion patients: clinical and microbial effects in adults and children. BMC Oral Health 2016; 16: 112.
  23. Niko B. Plaque control effectiveness and handling of international brushes during multibraches treatment-a randomized clinical trial. Eur J Ortod 2010;33:4008-13.
  24. Sharma NC, Lyle DM, Qaqish JG, Galustians J, Schuller R. Effect of a dental water jet with orthodontic tip on plaque and bleeding in adolescent patients with fixed orthodontic appliances. Am J Orthod Dentofacial Orthop. 2008;133:565–71.
  25. Schatzle M. In vitro tooth cleaning efficacy of manual toothbruches araund brackets Eur J Orthod 2009;31:103-7.
  26. Arnold S, Koletsi D, Patcas R, Eliades T. The effect of bracket ligation on the periodontal status of adolescents undergoing orthodontic treatment. A systematic review and meta-analysis. J Dent 2016; 54:13-24.
  27. McClanahan SF, Bartizek RD, Biesbrock AR. Identification and consequences of distinct Löe-Silness gingival index examiner styles for the clinical assessment of gingivitis. J Periodontol 2001;72:383-92.
  28. Cowell CR, Saxton CA, Sheiham A, Wagg BJ. Testing therapeutic measures for controlling chronic gingivitis in man: A suggested protocol. J Clin Periodontol 1975;2:231-40.
  29. Wang S, Y Yang,Po Hong. The effect of oral hygiene instruction intervention of by orthodontic patients. J Dent Sci 2007; 2:45-51.
  30. Addy M, Griffiths GS, Dummer PMH, Kingdon A, Hicks R, Hunter ML, et al. The association between tooth irregularity and plaque accumulation,gingivitis, and caries in 11-12-year-old children. Eu J Orthod 1988; 10:76-83.
  31. Özyemişci-Cebeci N, Ünver S, Nemli SK. A Comparative Study of Oral Health Attitudes and Behaviors in Dental Students. J Dent App 2014;1: 3-7.
  32. Davidovic B, Jankovic S, Ivanovic D, Grujicic I. Oral health assessment among dental students. Serbian Dent J 2012; 59:141-4.