Salivary Streptococcus mutans levels in patients with conventional and self-ligating brackets

Abstract

The objective of this study was to investigate the effect of bracket type (conventional and self-ligating) on the levels of Streptococcus mutans and total bacterial counts in whole saliva of orthodontic patients. Thirty-two male and female patients were selected using the following inclusion criteria: adolescents (mean age 13.6 years, range 11-17 years), fixed appliances in both arches, non-smoker, and no reported oral habits. Demographic and oral hygiene characteristics were determined for each subject. The patients were subdivided into two groups with random allocation of bracket type (conventional or self-ligating). An initial saliva sample was obtained before the initiation of treatment (T1) and a second sample 2-3 months following appliance bonding (T2). Salivary S. mutans and total bacteria were enumerated and analysed after growth in culture. The demographic and clinical characteristics of the samples were analysed with a t- or chi-square test, where applicable, to assess the random allocation of bracket group to participants. The results of S. mutans and total facultative bacterial counts were log transformed and statistically analysed with analysis of covariance with bracket (conventional versus self-ligating) as the categorical variable and initial total bacterial counts or initial S. mutans levels serving as the covariate. No difference was found in the demographics and oral hygiene indices between the two groups, verifying the random assignment of brackets to the population sample. The levels of S. mutans in whole saliva of orthodontically treated patients do not seem to be significantly different between conventional and self-ligating brackets. The pre-treatment levels of S. mutans are significant predictors of the levels of S. mutans after placement of orthodontic appliances, while this was not the case for total bacterial counts.

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

“…However, no significant differences were found between the groups for overall time. In accordance with this, Pandis et al 25 defined no difference in PI between SLBs and CBs with elastomeric ligation. Our result is in contrast with the findings of some researchers 7,8,12,17 who defined that elastomeric ligated CBs cause more plaque accumulation and periodontal inflammation than SLBs.…”

Changes in oral microbiota due to orthodontic appliances: a systematic review

“…Three studies [43,44,48] detected significant increases of gram-negative bacteria, respectively, at 3 and 6 months, followed by a decrease at 6 and 12 months. Ten studies [10,20,21,26,30,37,41,43,44,48] detected an increase in the percentage of gram-bacteria and A. actinomycetemcomitans . The study conducted by Alves de Souza et al [10] revealed a significant increase in gram-species with the use of elasticomeric rings (Table 5).…”

“…Eigh studies analyzed self-ligating braces (SLB) [9,14,24,37–40,54]. Two studies [14,40] revealed no differences for BOP and PI between SLB and CB, while Nalçac et al and Uzuner et al [54] demonstrated a worsening in SLB.…”

The effect of bracket ligation on the periodontal status of adolescents undergoing orthodontic treatment. A systematic review and meta-analysis

“…Negative effects on dental hard tissue [10][11][12][13][14][15][16] as well as on the periodontium [1, 7,15,[17][18][19][20][21][22][23][24][25] owing to orthodontic bands and brackets have been described, and several investigations showed that the presence of plaque at the gingival margin is the most important factor in the development of periodontal diseases [18,[26][27][28]. Several reports have highlighted the fact that orthodontic brackets are not only associated with noticeable periodontal adjustments, but that the method of archwire ligation onto fixed braces itself has an apparent influence on bacteria accumulation and periodontal status [2,5,9,29].…”

“…According to a number of studies an increase in biofilm accumulation has been reposted in patients with elastomeric ligatures [2,5,[29][30][31].…”