Debnath Puja, Bangi Sayeeda Laeque, Hussain Mohammed Feroze, Rafiq Shabir, Tousifulla Syed, Abdu Mufeed, Gupta Seema
Department of Periodontics, Agartala Government Dental College, Agartala, IND.
Department of Orthodontics and Dentofacial Orthopedics, Al Badar Rural Dental College and Hospital, Gulbarga, IND.
Cureus. 2024 Nov 22;16(11):e74281. doi: 10.7759/cureus.74281. eCollection 2024 Nov.
Introduction Gingival enlargement (GE) poses a significant problem during fixed orthodontic treatment (FOT). Thus, the primary aim of the current study was to evaluate the concentrations of biomarkers present in the gingival crevicular fluid (GCF) of individuals receiving FOT. The ancillary aim was to examine and compare biomarker levels among patients exhibiting GE undergoing FOT, those without GE undergoing FOT, and a control group comprising individuals not undergoing FOT and to assess the predictors for GE in patients undergoing orthodontic treatment. Materials and methods A cross-sectional observational study was conducted on 129 patients who were divided into three groups: group 1, controls (n=18); group 2, patients who underwent FOT without GE (n=89); and group 3, patients who underwent FOT with GE (n=22). The gingival index (GI), periodontal index (PI), and inflammatory biomarkers such as interleukin 6 (IL-6), transforming growth factor-beta 1 (TGF-β1), tumor necrosis factor-alpha (TNF-α), matrix metalloproteinase 9 (MMP-9), and prostaglandin E2 (PGE2) were estimated by enzyme-linked immunosorbent assay (ELISA) analysis at baseline (T0) and after one year of orthodontic treatment (T1). Results GE was observed in 22 (19.81%) of the 111 patients who were undergoing orthodontic treatment. No statistically significant differences were observed between the groups for GI, PI, and biomarkers at T0 (p>0.05), whereas there was a statistically significant increase in the levels of inflammatory biomarkers, GI, and PI in group 3, followed by group 2, compared to group 1 (p<0.05). Group 3 showed the greatest increase in the biomarker levels from T0 to T1 (IL-6, 3.66±1.91 pg/mL; TGF-β1, 7.52±3.85 pg/mL; TNF-α, 16.96±3.82 pg/mL; MMP-9, 30.72±7.07 pg/mL; PGE2, 78.29±20.53 pg/mL). GI and PI were strong predictors of GE, whereas biomarkers were weak predictors. Conclusion GE in patients with FOT was significantly associated with an increase in GI and PI due to insufficient oral hygiene, leading to increased levels of inflammatory biomarkers in the GCF.
牙龈增生（GE）在固定正畸治疗（FOT）期间是一个重大问题。因此，本研究的主要目的是评估接受FOT的个体龈沟液（GCF）中生物标志物的浓度。次要目的是检查和比较接受FOT且出现GE的患者、接受FOT但未出现GE的患者以及由未接受FOT的个体组成的对照组之间的生物标志物水平，并评估正畸治疗患者发生GE的预测因素。
对129例患者进行了横断面观察性研究，这些患者被分为三组：第1组为对照组（n = 18）；第2组为接受FOT但未出现GE的患者（n = 89）；第3组为接受FOT且出现GE的患者（n = 22）。在基线（T0）和正畸治疗一年后（T1），通过酶联免疫吸附测定（ELISA）分析估计牙龈指数（GI）、牙周指数（PI）以及炎症生物标志物，如白细胞介素6（IL - 6）、转化生长因子 - β1（TGF - β1）、肿瘤坏死因子 - α（TNF - α）、基质金属蛋白酶9（MMP - 9）和前列腺素E2（PGE2）。
在111例接受正畸治疗的患者中，有22例（19.81%）出现了GE。在T0时，各组之间的GI、PI和生物标志物无统计学显著差异（p>0.05），而与第1组相比，第3组的炎症生物标志物、GI和PI水平有统计学显著升高，其次是第2组（p<0.05）。从T0到T1，第3组的生物标志物水平升高幅度最大（IL - 6，3.66±1.91 pg/mL；TGF - β1，7.52±3.85 pg/mL；TNF - α，16.96±3.82 pg/mL；MMP - 9，30.72±7.07 pg/mL；PGE2，78.29±20.53 pg/mL）。GI和PI是GE的强预测因素，而生物标志物是弱预测因素。
FOT患者的GE与口腔卫生不足导致的GI和PI升高显著相关，进而导致GCF中炎症生物标志物水平升高。
