Improvement of self-performed oral hygiene among patients with braces and micro-implants: approbation of specifically designed plaque-controlled regime

Abstract

Background. Braces and micro-implants may serve as retention points for the dental plaque under the condition of insufficient everyday oral care, thus compromising oral hygiene level of orthodontic patients.
 Objective. The assess changes of oral hygiene among orthodontic patients with braces and micro-implants during the use of adapted specifically-designed plaque-controlled regime of self-performed oral hygiene measures.
 Material and Methods. Study group was formed out of 30 patients aged 18 to 50 years, who were planned to undergo orthodontic treatment with brace system and micro-implant. During the first month of orthodontic treatment patients used a toothbrush with thin bristles, during the second month – V-toothbrush, and during the third month – a two-row and monobundle toothbrush. The interdental hygiene was provided by the size-adjusted toothbrushes. Clinical assessment was provided with the use of hygienic indices (O’Leary, Green-Vermillion and Turesky).
 Results. At the period of first month after orthodontic treatment initiation O’Leary index increased abruptly to 52.6±6.4%, which stands for unsatisfactory oral hygiene level. Values of Turesky and Green-Vermillion indices increased twofold after orthodontic appliance attachment, and after first month of treatment their values were 1.98±0.31, and 2.12±0.34 points, respectively; while after third month of treatment – 0.99±0.1 and 1.19±0.14, respectively.
 Conclusions. Oral hygiene conditions were deteriorated among all patients, compared to the pre-treatment situation, which was caused by orthodontic appliances fixation. Oral hygiene of the patients with fixed orthodontic appliances should include usage of two-row toothbrush, which most efficiently clean the plaque above and under the brace arch; and a mono-bundle toothbrush for additional cleaning around brace locks, in gingival area, and around micro-implants.