Gingival Phenotype and Dental Crowding in Pediatric Patients
- Conditions
- Crowding, ToothGingival Diseases
- Registration Number
- NCT07205172
- Brief Summary
The diagnostic evaluation of the soft and hard tissues surrounding the tooth is one of the most crucial factors in clinical dental practice. It can influence treatment planning and decision-making in multidisciplinary dental care. Since different periodontal phenotypes respond differently to chemical, physical, and bacterial insults, or trauma during dental treatments, this aspect is considered essential in determining the outcome of therapy across many dental specialties.
Understanding the gingival phenotype can be of great importance in pediatric dentistry, as thick gingiva provides a solid and stable foundation for maintaining optimal oral hygiene and is one of the key elements in orthodontic treatment.
The bucco-lingual thickness of the gingiva, combined with the direction of tooth movement, is considered an important factor in soft tissue changes and in the development or progression of mucogingival defects. In cases of a thin phenotype, dehiscence and/or fenestrations may occur, predisposing the patient to gingival recession if the tooth is moved beyond the biological limits-i.e., outside the bony housing. The mandibular incisors have been identified as the teeth most susceptible to the development of labial recession.
Some malocclusions become evident as early as the early mixed dentition period. Intense changes in both soft and hard tissues occur during the growth and development of the stomatognathic system, as described in the literature, particularly during the mixed dentition phase. These changes can affect tooth position and the stability of periodontal tissues, making a proper evaluation of the gingival phenotype essential in pediatric patients.
Interceptive orthodontics plays a key role in the prevention and early management of malocclusions, helping to reduce the risk of developing mucogingival defects in adulthood. Early identification of a thin gingival phenotype allows for the implementation of preventive strategies, such as controlling tooth movement within biological limits and, if necessary, using gingival grafts before performing critical orthodontic movements.
Additionally, genetic, anatomical, and functional factors influence the gingival response to orthodontic forces. An accurate assessment of the gingival biotype, combined with personalized orthodontic planning, is essential to ensure effective treatment and long-term periodontal health.
Currently, there are no studies in the literature regarding the association between the severity of dental crowding and periodontal biotype in pediatric patients. Furthermore, the data available in the adult population are inconsistent: Kaya et al. demonstrated that, in adulthood, there is no correlation between the gingival phenotype and skeletal malocclusion. On the other hand, Kong et al. reported a correlation between a thin biotype in skeletal Class I and III, site-specific to the left mandibular central incisor, and also found a significant association between the thin phenotype and the normodivergent and hypodivergent groups.
To date, there is therefore no predictive model capable of identifying periodontal issues related to severe crowding.
The aim of this study is primarily to assess the periodontal phenotype in pediatric patients at different stages of dental transition and to investigate a possible association between a thin periodontal biotype and severe dental crowding in childhood.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 180
Not provided
Patient-related:
Children whose parents and/or legal guardians have not signed the informed consent, or patients who are not sufficiently cooperative, making it impossible to perform a routine dental examination.
Children with systemic diseases or undergoing medication that affects the gingival tissues.
Non-cooperative patients, including those with special needs.
Patients who have already undergone orthodontic treatment or are currently undergoing orthodontic treatment.
Tooth-related:
Presence of dental agenesis and/or dental anomalies.
Dental sites with mucogingival problems.
Children with systemic diseases or undergoing medication that affects the gingival tissues.
Non-cooperative patients, including those with special needs.
Patients who have already undergone orthodontic treatment or are currently undergoing orthodontic treatment.
Group 3: Presence in the arch of all four permanent mandibular incisors fully erupted (incisal edge at occlusal level), no clinical attachment loss, healthy gingiva or mild gingivitis (GI ≤ 1) during the late mixed dentition phase.
Group 4: Presence in the arch of all four permanent mandibular incisors fully erupted (incisal edge at occlusal level), no clinical attachment loss, healthy gingiva or mild gingivitis (GI ≤ 1) during the permanent dentition phase.
Patients aged between 5 and 16 years.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Description of Gingival Phenotype in Pediatric Patients The study start date will coincide with the protocol approval by the ethics committee and will continue for 24 months, of which 18 months are allocated for data collection and 12 months for data processing and analysis. Describe the gingival phenotype in pediatric patients with primary dentition (Group 1), early mixed dentition (Group 2), late mixed dentition (Group 3), and permanent dentition (Group 4).
- Secondary Outcome Measures
Name Time Method Comparison of Crowding Indices and Periodontal Biotype The study start date will coincide with the protocol approval by the ethics committee and will continue for 24 months, of which 18 months are allocated for data collection and 12 months for data processing and analysis. Compare the crowding indices and periodontal biotype in pediatric patients with primary dentition (Group 1), early mixed dentition (Group 2), late mixed dentition (Group 3), and permanent dentition (Group 4).