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The objective of this study was to evaluate the prevalence of gingival growth during multi-attachment orthodontic treatment and to prioritize its predicting factors, especially the quantity of biofilm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This comprehensive cross-sectional descriptive study was conducted on orthodontic patients aged 9 to 30 years, in good health, treated by a fixed appliance. Periodontal clinical parameters such as plaque index, gingival index, probing pocket depth, periodontal phenotype and gingival enhancement index were recorded. Likewise, the brushing habits and the date of the last scaling were noted. The orthodontic parameters studied were the duration of the treatment, the type of bracket, the alloys used for the arches and the type of ligatures. Descriptive statistics were carried out, and variables presenting\n                      <jats:italic>p<\/jats:italic>\n                      value\u2009&lt;\u20090.25 were included in a multivariate analysis to calculate the Odds Ratio (OR) of gingival enlargement\u201d.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 193 patients were included (16.38 \u00b1 4.89 years). Gingival growth occurred for 49.7% of patients included. The predisposing factors for this pathology during fixed orthodontic treatment were conventional metal brackets (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021), mouth breathing (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040), male gender (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035), thick periodontal phenotype (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043), elastomeric ligations (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), duration of treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022) and presence of plaque (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). After achievement of the logistic regression, only two factors remained related to gingival enlargement: metallic brackets (OR: 3.5, 95% CI: 1.1\u201310.55) and duration of treatment (OR: 2.03, 95% CI: 1.01\u20134.08). The amount of plaque would not be directly related to the development of gingival increase during orthodontic treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among the predisposing factors that underlie gingival growth during multi-attachment therapy, the amount of plaque is not found. The qualitative assessment of the plaque and its evolution during treatment could clarify the role of the biofilm in the occurrence of gingival overgrowth.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-021-01433-2","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T03:03:12Z","timestamp":1614135792000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Prioritization of predisposing factors of gingival hyperplasia during orthodontic treatment: the role of amount of biofilm"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7782-0558","authenticated-orcid":false,"given":"S\u00e9verine","family":"Vincent-Bugnas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Borsa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apolline","family":"Gruss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Lupi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,24]]},"reference":[{"key":"1433_CR1","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1016\/j.ajodo.2016.10.042","volume":"152","author":"AS Pinto","year":"2017","unstructured":"Pinto AS, Alves LS, do Zenkner JE, Zanatta A, Maltz FB. 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New Microbiol. 2008;31:299\u2013302.","journal-title":"New Microbiol"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-021-01433-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12903-021-01433-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-021-01433-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T03:03:23Z","timestamp":1614135803000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcoralhealth.biomedcentral.com\/articles\/10.1186\/s12903-021-01433-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,24]]},"references-count":47,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1433"],"URL":"https:\/\/doi.org\/10.1186\/s12903-021-01433-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.2.14100\/v1","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.2.14100\/v2","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.2.14100\/v3","asserted-by":"object"}]},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,24]]},"assertion":[{"value":"25 August 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The research commission of the UFR of odontology of Nice University validated the study and the Delegation for Clinical Research and Innovation of University Hospital of Nice agreed to carry out this study. This study was registred, according to the Data protection act (loi informatique et libert\u00e9) (# 409). An informed written participant consent was obtained for each participant.  For the minors included in the patient sample the consent to participate was obtained from a parent or guardian on behalf of the participants (Additional file\n                      \n                      ).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"84"}}