Benefit of orthodontic treatment in reducing anterior mandibular crowding

 # The benefit of orthodontic treatment in reducing anterior mandibular crowding is often linked to the reduction of Gingival Index scores. This is primarily because proper alignment leads to:

A. A greater volume of keratinized tissue around the incisors

B. A reduction in plaque accumulation and gingival inflammation

C. Increased vascularity and nutrient supply to the PDL

D. Increased resistance to future recession and attachment loss

The correct answer is B. A reduction in plaque accumulation and gingival inflammation

Severe anterior mandibular crowding creates plaque-retentive interproximal and gingival crevices, elevating Gingival Index scores by 1–2 points on average due to chronic low-grade inflammation from bacterial accumulation. Orthodontic alignment (e.g., via archwire sequencing or IPR) enhances self-performed oral hygiene efficacy—reducing plaque index by 25–40% and GI by 0.5–1.0 within 6–12 months, as shown in randomized trials—by facilitating direct bristle/floss access and disrupting biofilm habitats. This direct causal pathway outperforms secondary effects like tissue volume gains (A, minimal post-alignment), PDL vascular changes (C, unrelated to surface inflammation), or recession resistance (D, a downstream periodontal outcome rather than primary GI driver).