title: Impact of body mass index on oral health during orthodontic treatment: an explorative pilot study.
abstract: To answer the question: is there a correlation between body mass index (BMI), oral health, and patient cooperation during multibracket (MB) appliance therapy?
  
  
  
  All adolescent MB patients started and finished between 2007 and 2012 were analysed. According to their pre-treatment BMI, patients were divided into one of the following groups: normal weight, overweight, or obese. Using the patients' records, the cooperation during treatment was classified as good, bad, or poor and the treatment duration was calculated. Using pre- and post-treatment photographs, white spot lesion (WSL) formation and gingivitis before and after MB therapy were assessed.
  
  
  
  Of the 175 subjects, 138 had a normal BMI (79 per cent), 22 were overweight (12.5 per cent), and 15 obese (8.5 per cent). Whereas 42.8 per cent of the normal weight patients showed a good cooperation, only 22.7 per cent of the overweight and 20.9 per cent of the obese patients cooperated sufficiently. On average, normal weight patients were treated for 22.2 months, overweight patients for 23.0 months, and obese patients for 27.7 months. Normal weight patients developed less WSL (41.3 per cent) during MB treatment than overweight (50 per cent) or obese (66.7 per cent) patients. Furthermore, patients with a normal weight or overweight had less gingival inflammation (79.5 per cent) after treatment than obese individuals (93.3 per cent).
  
  
  
  An increased BMI appears to be a risk factor for less cooperation, a longer treatment duration, and more oral health-related problems during MB treatment, indicating that these patients require special attention during orthodontic therapy.
authors.affiliation: Department of Orthodontics, University of Giessen, Germany julia.v.bremen@dentist.med.uni-giessen.de.
authors.forename: Julia
authors.initials: J
authors.lastname: von Bremen
authors.affiliation: Department of Orthodontics, University of Giessen, Germany.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Lorenz
authors.affiliation: Department of Orthodontics, University of Giessen, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Ruf
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D003731:Dental Caries / Q000209:etiology; D005260:Female; D005891:Gingivitis / Q000209:etiology; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology*; D009909:Oral Health; D009967:Orthodontic Appliances / Q000009:adverse effects*; D009971:Orthodontics, Corrective / Q000009:adverse effects / Q000523:psychology; D050177:Overweight / Q000523:psychology*; D010349:Patient Compliance; D010865:Pilot Projects; D012189:Retrospective Studies; D012307:Risk Factors