Orthodontic attachments and chlorhexidine-containing varnish effects on gingival health.
OBJECTIVE
To compare the severity of clinical inflammation parameters and the level of the inflammatory mediator interleukin (IL)-1beta during orthodontic treatment by using brackets and bands. In addition, the effect of a chlorhexidine-containing varnish was investigated.


METHODS
This prospective randomized controlled trial included 40 healthy children who required an orthodontic treatment of mild crowding. Either brackets or bands were randomly allocated to the premolars with a split-mouth design. Twenty of the children received a chlorhexidine-containing varnish during the treatment (0, 12, 24 weeks), while the remaining children served as a control group. Prior and until 24 weeks after the insertion, data were recorded regarding the pocket depth (PD), the gingival appearance (gingival index [GI]), and the plaque accumulation (plaque index [PI]). Gingival crevicular fluid was collected as well. A quantitative enzyme-linked immunoassay technique was used to detect differences in IL-1beta.


RESULTS
The PDs and the gingival index of teeth with brackets showed significantly lower values in comparison with teeth treated with bands (P = .0001). The IL-1beta levels confirmed these findings. In contrast, the PI showed higher values for the teeth with brackets (P = .0001). The teeth that received a chlorhexidine-containing varnish showed significantly lower values in the follow-ups for most of the evaluated parameters (PD Band, PI Band, PI Bracket, GI Band, GI Bracket; P < .015).


CONCLUSIONS
The clinically observed parameters as well as the IL-1beta levels reflected the higher impact of bands on gingival health. These values showed a significant decrease after application of a chlorhexidine-containing varnish. However, the PI showed higher values for the teeth with brackets.
Paschos
Ekaterini
E
Department of Orthodontics, Dental School, Ludwig-Maximilians-University, Munich, Germany. epaschos@med.uni-muenchen.de
Limbach
Mirjam
M
Teichmann
Marion
M
Huth
Karin C
KC
Folwaczny
Matthias
M
Hickel
Reinhard
R
Rudzki-Janson
Ingrid
I
D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D001641:Bicuspid / Q000473:pathology; D002648:Child; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use*; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D005883:Gingival Crevicular Fluid / Q000737:chemistry; D005882:Gingival Diseases / Q000145:classification*; D005885:Gingival Hyperplasia / Q000145:classification; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis; D053583:Interleukin-1beta / Q000032:analysis; D008137:Longitudinal Studies; D008297:Male; D008310:Malocclusion / Q000628:therapy; D009967:Orthodontic Appliances; D016910:Orthodontic Brackets; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D011446:Prospective Studies
D000891:Anti-Infective Agents, Local; D018836:Inflammation Mediators; D053583:Interleukin-1beta; D002710:Chlorhexidine