Abstract:

Patients undergoing long-term orthodontic treatment with fixed appliances often have difficulties in maintaining adequate oral hygiene. As a result of poorly cleaned plaque, gingival inflammation develops, accompanied by bleeding from the marginal gingival tissues. On the other hand, the use of bonded orthodontic retainers requires a certain preparation of the lingual surfaces of the anterior teeth. One of the most common reasons for the debonding of these retainers is poorly cleaned and unpolished tooth surfaces, as well as the inability to dry the field due to abundant gingival bleeding. The aim of the present study was to analyze the effect of ultrasonic cleaning of bacterial plaque with subsequent polishing of the dentition on the reduction or of gingival inflammation, assessed by taking into account the superficial bleeding index (FMBS). It would also be essential to determine a suitable time range for bonding the fixed retainers after ultrasonic cleaning and polishing.
The clinical study included 31 individuals aged 13 to 32 years, divided into two groups, randomly: Group 1 with 15 patients and Group 2 with 16 patients. Patients in Group 1 were recalled after 72 hours for a second FMBS, and patients in Group 2 had a second FMBS after 24 hours. A clinical periodontal examination was performed in all patients and the following parameters were measured: FMPS (Full mouth plaque score) and FMBS (Full mouth bleeding score). The examination was performed with a periodontal probe (UNC-15) on each incisor and canine tooth in the upper and lower jaw, and the presence of dental plaque and gingival bleeding in four places around each tooth was recorded. Each participant received instructions for better personal oral hygiene. All patients underwent a single scaling and polishing procedure on all teeth and the dentition was polished as part of the preparation of the lingual surface of the anterior teeth for better adhesion of orthodontic retainers. We found that in patients from group 1, who were called for a second visit on the third day, FMBS was reduced from 37% to 13% for the maxilla and from 66% to 33% for the mandible, with a strong statistical significance in the reduction of gingival bleeding (p=0.001 for the maxilla and p=0.0001 for the mandible). Our results show a stronger reduction in gingival bleeding on the third day after cleaning and polishing compared to bleeding on the next day, with this reduction being statistically significant for the maxilla (p=0.02).

Keywords: Orthodontic retainer, gingival inflammation, gingival bleeding