title: The association of orthodontic treatment and fixed retainers with gingival health.
abstract: BACKGROUND
  The use of postorthodontic fixed retainers made of wire and composite resin bonded to the lingual/palatal tooth aspect is a common practice that can affect gingival health. The purpose of this study was to evaluate the association of orthodontic treatment and fixed retainers with gingival health.
  
  
  METHODS
  The study included 92 consecutive subjects who arrived for routine dental examination at a military dental clinic between May and August 2007. Plaque and gingival indices, gingival recession, probing depth, and bleeding on probing were measured at the anterior sextants. When a fixed retainer was present, the distance was measured between the retainer and incisal edge and to the cemento-enamel junction. Past orthodontic treatment and smoking habits were self-reported. Postorthodontic patients were sorted by the presence or absence of fixed retainers.
  
  
  RESULTS
  The mean probing depth was 1.90 +/- 0.2 mm, and gingival recession was 0.06 +/- 0.02 mm; 20.8% of all sites exhibited bleeding on probing. Current smoking was reported by 20 (21.7%) patients. Labial gingival recession was significantly greater in treated (0.13 +/- 0.2 mm) patients compared to non-treated patients (0.05 +/- 0.2 mm; P = 0.03). Localized lingual gingival recession was significantly greater in teeth with fixed retainers (0.09 +/- 0.2 mm) compared to teeth with no fixed retainers (0.01 +/- 0.1 mm; P = 0.0002), as were plaque and gingival indices and bleeding on probing. Plaque on the lingual/palatal aspect showed a weak, positive correlation with lingual gingival recession (r = 0.16; P = 0.033).
  
  
  CONCLUSIONS
  Orthodontic treatment and fixed retainers were associated with an increased incidence of gingival recession, increased plaque retention, and increased bleeding on probing; however, the magnitude of the difference in recession was of low clinical significance.
authors.affiliation: Department of Oral and Dental Medicine, Rambam Health Care Campus, Haifa, Israel. liranl@post.tau.ac.il
authors.forename: Liran
authors.initials: L
authors.lastname: Levin
authors.forename: Gili R
authors.initials: GR
authors.lastname: Samorodnitzky-Naveh
authors.forename: Eli E
authors.initials: EE
authors.lastname: Machtei
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D003773:Dental Plaque / Q000209:etiology*; D005260:Female; D005881:Gingiva / Q000502:physiology*; D005889:Gingival Recession / Q000209:etiology*; D005891:Gingivitis / Q000209:etiology*; D006801:Humans; D008297:Male; D018704:Orthodontic Retainers / Q000009:adverse effects*; D009971:Orthodontics, Corrective / Q000009:adverse effects / Q000295:instrumentation; D010512:Periodontal Index; D010518:Periodontitis / Q000209:etiology; D018709:Statistics, Nonparametric; D055815:Young Adult