Effects of fixed orthodontic brackets on oral malodor

Abstract

Background:This systematic review and meta-analysis aimed to identify whether there is any relationship between fixed orthodontic appliances and malodor, and if self-ligating brackets (SLBs) prevent malodor better than conventional brackets (CBs).Methods:The electronic databases PubMed, Ovid, EMBASE, and the Cochrane Library were searched from inception to September 2016; a manual search was also performed. Randomized controlled and clinical controlled trials, in which experimental groups received fixed orthodontic therapy and malodor was measured, were included. Patients treated with fixed orthodontic brackets were compared with those without any treatment, and SLB systems were compared with CB systems. Two reviewers independently selected potentially relevant studies, evaluated the risk for bias, extracted essential data, and synthesized findings using Review Manager version 5.3 (Copenhagen: The. Nordic Cochrane Centre, The Cochrane Collaboration, 2014).Results:Four studies, involving a total of 152 participants, met the inclusion criteria. Fixed orthodontic appliances caused malodor from the initial visit to 2 to 3 months, but was only significant after the first week (mean difference 20.24 [95% confidence interval [CI]11.75–28.74]; P < .00001). Plaque index, gingival index, and periodontal pocket depths demonstrated no statistical differences between the SLB and CB groups after the first week. However, SLBs significantly controlled malodor better than CBs after the first week (mean difference 4.32 [95% CI 6.02 to 2.61]; P < .00001). The quality of the included studies was relatively low and relevant research in this field is quite scarce.Conclusions:Although the evidence base was relatively weak, fixed orthodontic treatment appeared to be a risk factor for malodor, independent of periodontal changes, and SLB systems controlled malodor better than CB systems.

Evaluation of Changes in Cariogenic Bacteria in a Young Moroccan Population with Fixed Orthodontic Appliances

“…In our study, we also distinguished the appearance of these germs after 3 months of fitting the orthodontic apparatus [8]. The literature results show that Klebsiella pneumoniae and Enterobacter cloacae , which are anaerobic and do not need air or dioxygen to function, are among the major causes of halitosis [9]. Rosembloom and Tinanoff found that orthodontic treatment would result in a change in oral flora with a remarkable increase in cariogenic bacteria counts (including oral streptococci) in dental plaque and saliva [10].…”

An Umbrella Review of Systematic Reviews With or Without Meta-Analysis Assessing Treatment Outcomes and Efficiency of Self-Ligating Brackets

“…The risk of bias in 10 studies was low, [9][10][11]14,15,[17][18][19]21,23 while it was unclear in 6. 12,13,16,20,22,24 The methodological quality of almost all studies was positive to signaling questions in domains 1 and 4 of phase 2 of ROBIS.…”

“…19 2 studies measured plaque index, gingival index, bleeding on probing, and periodontal pockets but found no significant differences between selfligating and conventional brackets. 17,21 Huang et al found that oral malodors were less with self-ligating brackets. 21 No statistical differences in chairside time were observed in the study conducted by Chen et al 9 Yang et al 18 reported a shorter treatment time when using conventional bracket systems.…”

“…17,21 Huang et al found that oral malodors were less with self-ligating brackets. 21 No statistical differences in chairside time were observed in the study conducted by Chen et al 9 Yang et al 18 reported a shorter treatment time when using conventional bracket systems. No significant differences were observed in other clinical parameters such as pain, discomfort, and overall treatment time.…”

Effectiveness of Riboflavin and Rose Bengal Photosensitizer Modified Adhesive Resin for Orthodontic Bonding

“…The factors responsible for the increased development of bacterial biofilm include the application of orthodontic appliances close to the soft tissue structures, malaligned teeth, and improper oral hygiene maintenance [ 6 ]. The abundance of bacterial biofilm can lead to the development of oral health problems that include plaque-induced gingivitis, white spot lesions, and oral malodor (bad breath) [ 7 , 8 , 9 , 10 ]. The most common treatment modality used to tackle this problem addresses the repeated application of scalers (manual or ultrasonic).…”