Self-ligating versus conventional metallic brackets on Streptococcus mutans retention: A systematic review

Abstract

Objective:The present study aimed to review the literature systematically and assess comparatively whether self-ligating metallic brackets accumulate less Streptococcus mutans biofilm than conventional metallic brackets.Material and methods:The systematic search was performed following PRISMA guidelines and registration in PROSPERO. Seven electronic databases (Google Scholar, LILACS, Open Grey, PubMed, SciELO, ScienceDirect, and Scopus) were consulted until April 2016, with no restriction of language and time of publication. Only randomized clinical studies verifying S. mutans colonization in metallic brackets (self-ligating and conventional) were included. All steps were performed independently by two operators.Results:The search resulted in 546 records obtained from the electronic databases. Additionally, 216 references obtained from the manual search of eligible articles were assessed. Finally, a total of 5 studies were included in the qualitative synthesis. In 1 study, the total bacterial count was not different among self-ligating and conventional brackets, whereas in 2 studies the amount was lower for self-ligating brackets. Regarding the specific count of S. mutans, 2 studies showed less accumulation in self-ligating than in conventional brackets.Conclusion:Based on the limited evidence, self-ligating metallic brackets accumulate less S. mutans than conventional ones. However, these findings must be interpreted in conjunction with particularities individual for each patient – such as hygiene and dietary habits, which are components of the multifactorial environment that enables S. Mutans to proliferate and keep retained in the oral cavity.

Comparación de Brackets de Autoligado y Brackets Convencionales basada en la evidencia

“…Además en relación a la comodidad del paciente, existe un mayor malestar con los brackets de autoligado, pero que no es estadísticamente significativo (32,33,71,(73)(74)(75)(76)(77)(78)(79)(80)(81) . Por último al analizar la higiene entre ambos brackets, al igual que los estudios clínicos, los resultados de las revisiones sistemáticas igualmente son contradictorios, unos concluyendo que no existen diferencias y otros que los brackets de autoligado acumulan menos Streptococus mutans, por lo que no se tiene una certeza clara en relación con este tema (1,21,(81)(82)(83)(84)(85)(86)(87)(88)(89)(90)(91)(92)(93)(94)(95)(96) .…”

“…Algunas revisiones sistemáticas concluyen que los brackets metálicos de autoligado acumulan menos Streptococus mutans que los brackets metálicos convencionales. Sin embargo, sugieren que estos hallazgos deben interpretarse en conjunto con las características individuales de cada paciente, como la higiene y los hábitos alimenticios (94) . Otros resultados muestran que los brackets de autoligado no superan a los brackets convencionales en promover una mejor salud oral (81) y otros arrojan que no hay evidencia de una posible influencia del diseño de los brackets (convencionales o autoligados) sobre la formación de colonias y la adhesión de Streptococcus mutans (1,95) .…”

Streptococcus mutans adherence to conventional and self-ligating brackets: an in vitro study

“…However, despite possible differences, the results demonstrated here have limited clinical applicability, as already mentioned. Clinical studies still present controversial conclusions regarding the influence of bracket design (conventional versus self-ligating) on SM colony formation and adhesion 39 or upon oral microbiota alteration. 40 However, according to data collected by a systematic review, 41 the periodontal status of orthodontic patients seems to remain equally altered, whether by the use of conventional or self-ligating brackets.…”

Toxicological Assessment of an Acrylic Removable Orthodontic Appliance Using 2D and 3D In Vitro Methods

“…Although conventional orthodontic fixed appliances have proven useful in the treatment of malocclusion, they are not without side effects. The most common problems that can occur during orthodontic treatment include changes in oral pH and the development of cavities, gingivitis, and periodontitis [ 14 ]. The main cause of these side effects is poor hygiene of orthodontic patients.…”