Impact of Increased Body Mass Index on Adolescent Fixed Orthodontic Treatment. A Prospective Longitudinal Study

Inclusion Criteria: * adolescents (12-17 years old); * patients scheduled to undergo comprehensive fixed orthodontic therapy (OT) (for at least 6 months with metal braces/wires) on both dental arches; * patients with increased BMI (≥25.0 Kg/m2) (test-Group); * patients with normal BMI \[18.5-24.99 (Kg/m2)\] (control-Group); * patients with all 6 mandibular anterior teeth present and mild-to-moderate mandibular crowding (\<7.5 mm); * patients and parents/guardians willing to provide signed assent/permission. Exclusion Criteria: * self-reported habitual tobacco product users; * patients with self-reported medical diseases such as hepatic diseases, blood disorders, cardiovascular diseases, HIV, diabetes mellitus, and viral infections; * patients with craniofacial syndromes and/or cleft lip and palate; * pregnant and/or lactating females (by self/parent report); * edentulous individuals; * patients with active or a history of periodontitis; * patients having undergone surgical and/or non-surgical periodontal therapy within the past 6 months; * patients with physical and/or mental/cognitive disabilities who are decisionally-impaired and not able to consent/assent for themselves; * patients who reported use of medications such as antibiotics, steroids (inhalers and/or pills), non-steroidal anti-inflammatory drugs, and antimicrobial mouth-rinses within the past 3 months or those who require prophylactic antibiotics prior to dental procedures; * patients undergoing cancer therapy; * underweight patients (BMI less than 18.5 Kg/m2); * patients with oral mucosal lesions such as median rhomboid glossitis and lichen planus; * patients with clinically visible carious teeth.