Effect of bracket type on halitosis, periodontal status, and microbial colonization

Abstract

Objective: To determine the effect of bracket type on halitosis, periodontal status, and microbial colonization. Materials and Methods: Forty-six patients scheduled for fixed orthodontic treatment (age 11-16 years) were selected from the orthodontic department of Suleyman Demirel University. Patients were divided into two groups with random distribution of brackets; 23 patients were treated with self-ligating brackets (group SLBs), the others with conventional brackets (group CBs). Halitosis measurements and periodontal and microbial records were obtained before the placement of brackets (T0), 1 week later (T1), and 5 weeks after bonding (T2). Periodontal parameters, including plaque index (PI), gingival index (GI), and bleeding on probing index (BOP), were obtained from all the bonded teeth. Halitosis measurements were performed at the same time. Microbial samples were obtained from the buccal surfaces of all the bonded teeth. Data were analyzed by using a repeated-measurement analysis of variance test for the comparison of parameters between groups and times. Results: Periodontal parameters and halitosis results were higher in the CBs group than in the SLBs group (P , .05). In the SLBs group, halitosis and BOP values revealed no pronounced changes between T1 and T2 (P . .05). Intra-and intergroup comparisons showed that there were no statistically significant differences for microbial colonization between all the time intervals (P . .05). Conclusion: Bracket type has an effect on halitosis and periodontal status. Therefore, self-ligating brackets may be advised in order to prevent patients from developing halitosis and to increase the likelihood of good oral hygiene during orthodontic treatment. (Angle Orthod. 2014;84:479-485.)

Effects of self-ligating and conventional brackets on halitosis and periodontal conditions

“…There is only one study comparing SLBs with conventional brackets (CBs) ligated with elastic ligatures on halitosis. 12 However, we were unable to obtain any study comparing periodontal status and halitosis in the orthodontic treatments performed with conventional bracket systems with wire ligation and self-ligating brackets. Therefore, this prospective study was performed to investigate the effect of fixed orthodontic treatment with SLBs and steel-ligated CBs on CBs control group on halitosis, periodontal status in comparison with a control group; secondly, the investigation focused on the effect of oral hygiene, primarily tongue cleaning.…”

“…[7][8][9] Periodontal inflammation, hyperemia, hyperplasia, and demineralization of the teeth have been found as a result of failure of ensuring adequate oral hygiene. [10][11][12][13] It has been stated that accumulation of plaque and the increase in bacterial count 7,8,12,14 and tongue coating 2,6 clearly are also involved in the formation of halitosis. Determining the bracket system that causes a minimal destructive biologic effect has gained importance today.…”

“…3,5,6 The effects of orthodontic treatment on periodontal status have been evaluated in several studies. [7][8][9][10][11][12] The brackets and ligatures have a negative effect on natural cleaning by creating retention areas for plaques, making the mechanical cleaning of the teeth and gingiva by the tongue and lips more difficult, and increasing the viscosity of the saliva. [7][8][9] Periodontal inflammation, hyperemia, hyperplasia, and demineralization of the teeth have been found as a result of failure of ensuring adequate oral hygiene.…”

Are self-ligating brackets an advantageous alternative for non-extraction treatments?

“…On the other hand, there was no difference in the amount of bacterial colonization between the conventional and the self-ligating types of brackets 29 .…”

“…-randomized trials have been done but there are too few 14,24,29,38 ; -samplings are low 24,29,36 ; -systematic reviews and metaanalyses only allow us to assess a few high caliber articles 16,30 . In addition, it is important to note that most of the studies were carried out with just a few bracket models even though there are many different brands: Smart Clip TM (3M Unitek, Monrovia, Calif) 4 …”