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Risk factors for gingival invagination: A retrospective study.

M Han1, S H Li1, Y Yao1

  • 1Department of Orthodontics, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, China.

Journal of Clinical Periodontology
|May 24, 2024
PubMed
Summary

Gingival invagination risk during orthodontic treatment is higher with buccal bone thickness less than 1mm (MB1) and in patients with normodivergent or hyperdivergent skeletal patterns. These factors are crucial for predicting and preventing this orthodontic complication.

Keywords:
gingivaorthodonticsperiodontal diseasesrisk factorstooth extraction

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Area of Science:

  • Orthodontics
  • Periodontology
  • Dental Imaging

Background:

  • Gingival invagination is a potential complication during orthodontic treatment.
  • Premolar extraction is a common procedure in orthodontics, often followed by space closure.
  • Identifying risk factors for gingival invagination is essential for patient management.

Purpose of the Study:

  • To identify and analyze the risk factors associated with gingival invagination after premolar extraction during orthodontic treatment.
  • To develop a predictive model for gingival invagination.

Main Methods:

  • Retrospective analysis of 135 patient records.
  • Cone beam computed tomography (CBCT) for assessing gingival invagination.
  • Statistical analysis using mixed-effects models and generalized propensity score weighting (GPSW).

Main Results:

  • Buccal bone thickness 4 mm apical to the cemento-enamel junction (MB1) less than 1 mm significantly increased the risk of gingival invagination (OR > 22).
  • Vertical skeletal relationships, specifically normodivergent and hyperdivergent patterns, were also associated with a higher risk.
  • The predictive models developed demonstrated good performance with an area under the curve exceeding 0.7.

Conclusions:

  • Reduced buccal bone thickness (MB1 < 1 mm) is a primary risk factor for gingival invagination.
  • Normodivergent and hyperdivergent vertical skeletal patterns increase the likelihood of this complication.
  • These findings aid in predicting and potentially preventing gingival invagination in orthodontic patients undergoing premolar extraction.