title: Orthodontic attachments and chlorhexidine-containing varnish effects on gingival health.
abstract: 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.
authors.affiliation: Department of Orthodontics, Dental School, Ludwig-Maximilians-University, Munich, Germany. epaschos@med.uni-muenchen.de
authors.forename: Ekaterini
authors.initials: E
authors.lastname: Paschos
authors.forename: Mirjam
authors.initials: M
authors.lastname: Limbach
authors.forename: Marion
authors.initials: M
authors.lastname: Teichmann
authors.forename: Karin C
authors.initials: KC
authors.lastname: Huth
authors.forename: Matthias
authors.initials: M
authors.lastname: Folwaczny
authors.forename: Reinhard
authors.initials: R
authors.lastname: Hickel
authors.forename: Ingrid
authors.initials: I
authors.lastname: Rudzki-Janson
mesh_terms: 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
chemical_list: D000891:Anti-Infective Agents, Local; D018836:Inflammation Mediators; D053583:Interleukin-1beta; D002710:Chlorhexidine