Gingival Enlargement Post-orthodontic Treatment

Graduate Orthodontic Clinic

Inclusion Criteria:

• Modified Seymour Gingival Encroachment index ≥30% in the labial anterior sextants at the time the removal of fixed orthodontic appliances.
• Age 11 to 19 at the time the fixed orthodontic appliances were first placed.
• On fixed orthodontic appliances for a minimum of 18 months.

Exclusion Criteria:

b. Exclusion criteria

1. Active periodontitis, defined by the presence of clinical attachment loss (CAL) on any of the 12 anterior teeth at the time of orthodontic bracket debonding

2. Does not have/does not use a smartphone (FOR QUALTRICS)

3. Pregnant patients

4. History of periodontal surgery

5. Patients not able to give consent due to intellectual disabilities

6. Patients with medication which can induce GE (e.g. calcium channel blockers, anticonvulsants/phenytoin, Ciclosporin)

7. Subjects diagnosed with conditions which can present with GE (e.g. leukemia, vitamin C deficiency, plasma cell gingivitis, soft tissue pathology, hereditary gingival fibromatosis)

   • Patients with prominent defective restorations

     c. Exit criteria

   • Patients developing conditions that result in them meeting any of the above exclusion criteria (e.g., starting a medication that is known to affect the gingiva).

   • Patients requiring surgical periodontal therapy or other urgent treatment on the anterior sextants, at any time point during the study.

   • Patients unable or unwilling to continue in the study.

   • Patients missing the initial (3-7 weeks) postoperative visit.

   • Patients who fail to complete the questionnaire at the applicable visit.