Risk factors for gingival invagination: A retrospective study

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.