Pacientes ortodônticos são um grupo de risco para lesão cervical não cariosa e recessão gengival? um estudo retrospectivo

Abstract

Non-carious cervical lesion (NCCL) is characterized by the loss of dental structure near the cemento-enamel junction. These have a multifactorial etiology and have as main factors the tension, biocorrosion and friction. Regarding the concentration of tension, orthodontic treatment (OT) can act as a cyclic force. OT is associated with changes in oral hygiene habits and periodontal health, creating a region favorable to the development of gingival recession (GR). The objective of this study was to evaluate the effect of OT as a risk factor for the development and progression of NCCL and GR, with a retrospective clinical study. Approved by CEP-UFU (1,382,955). After inclusion and exclusion criteria, 160 patients who underwent OT were selected, aged between 10-52 years, divided into <20, 21-35,> 35 years; And number of activations between 6-63 sessions, divided into 6-18, 19-36,> 36. The analyzes were by charts and photographs already preexisting from the beginning and end of OT, with qualitative analysis of NCCLs and Tooth Wear, and quantitative GR. Performed by two calibrated and independent operators, with a third for tiebreaker. A Kappa value> 0.8 was obtained. Statistical analysis was performed using odds ratio and chi-square test for association of risk factors related to orthodontic patient profile and NCCLs. Analyzes associated with NCCLs were performed using the Wilcoxon, Mann- Whitney, Kruskal-Wallis and Dunn test. Data related to GR did not present normal distribution and the analysis was performed in the same manner as NCCLs. The prevalence of NCCL was 60.62% before and 76.25% after OT, the teeth most affected were the premolars. In the before OT analysis, when compared to the group up to 20 years, patients aged 21-35 years and> 35 years presented a 4.57 and 6.40 higher risk of having NCCL. In the analysis after TO, patients aged between 21 and 35 years and> 35 years, presented 3.87 and 7.74 more chances to have NCCL; And patients with maxillary atresia presented 0.25 chances of having NCCL. For both NCCL and GR, there was a significant statistical difference before and after OT. There was a correlation between the number of NCCLs and the age group, the higher the number of NCCLs. There was a greater increase in GR size in the group> 35 years and significant statistical difference between the groups. For the NCCL, the number of activation sessions of group 6 to 18 was statistically different from the groups of 19 to 36 and> 36 than 16 activations. However, for GR, there was no statistical difference between the activation session groups. The lingual torque promoted a different data distribution compared to the vestibular torque, and demonstrated a more intense effect on the increase of the NCCL size. OT can be considered a risk factor for NCCL and GR, along with the age factor and the number of activations, therefore, sums of factors should be avoided and there should be a control of the other etiological factors related to NCCL and GR.