Relationship between Malocclusion and Periodontal Disease in Patients Seeking Orthodontic Treatment in Southwestern Saudi Arabia

BACKGROUND: Malocclusion is known to cause plaque accumulation and periodontal breakdown. However, no previous study from Saudi Arabia has assessed this relationship in patients seeking orthodontic treatment for esthetics. OBJECTIVE: The objective of this study was to investigate the relationship between malocclusion and periodontal disease in terms of gingival inflammation, probing pocket depth (PPD) and recession in patients seeking orthodontic treatment for esthetic improvement. MATERIALS AND METHODS: This prospective cross-sectional study was conducted at the Outpatient Division of Periodontics, College of Dentistry, King Khalid University, Saudi Arabia, among consecutive new patients seeking orthodontic treatment for esthetic improvement between June and August 2018. Angle’s class of malocclusion, various malalignments, plaque index (PI), gingival index (GI), adequacy of width of attached gingiva (WAG), response to fremitus test, PPD and gingival recession (GR) were recorded. P < 0.05 was considered statistically significant. RESULTS: A total of 410 consecutive patients were included. Of these, 314 patients had Class I, 57 had Class II (division I), 25 had Class II (division II) and 14 had Class III malocclusions. In patients with all types of malocclusion, the majority had a PI and GI of score 2 (74.1% and 83.7%, respectively). Most of the patients (85.9%) had adequate WAG; similarly, 94.9% had a negative fremitus test, which shows the absence of trauma from occlusion. Mean PPD and GR in the maxillary and mandibular arches showed varying results. CONCLUSION: This study demonstrates a relationship between malocclusion and presence of periodontal disease in patients seeking orthodontic treatment for esthetic improvement in the southwestern region of Saudi Arabia. Therefore, in patients seeking orthodontic treatment, careful evaluation of gingival and oral hygiene along with adequacy of attached gingiva should be considered.