Salivary pH Changes and Biofilm Formation During Active Orthodontic Treatment with Clear Aligners and Fixed Appliances
Year 2024,
, 334 - 340, 28.06.2024
Yousef Y. M. Abu Ebaid
,
Yasemin Bahar Acar
Abstract
Objective: To examine salivary pH changes and the plaque formation in two different orthodontic treatments clinically.
Methods: The study sample included 40 patients, who were divided into two groups according to the type of orthodontic appliance: Group CA, (n=15) clear aligners; Group FT, (n=25) fixed appliances. Group FT received both metal (FT/SS) and elastic ligatures (FT/EM) for 2 weeks respectively to test the effect of ligature type also. Salivary pH values, plaque index, and plaque percentage were measured at T0 (after scaling and polishing) and T1 (after 2 weeks). pH was measured with a digital caliper (HI 2211 pH/ORP Meter) and plaque was identified by a discoloring agent (Tri Plaque ID Gel). The Paired t-test, Independent t-test, Anova test and Pearson Correlation tests were used in the statistical analysis.
Results: There was significant decrease in salivary pH values after two weeks of metal ligature in FT/SS. Plaque index and plaque percentage parameters showed significant incremental changes between groups with the least increase in CA, followed by FT/SS and FT/EM respectively.
Conclusion: Different types of orthodontic treatment and ligatures significantly effected salivary pH and the amount of plaque formation during orthodontic treatment. Aligners had the least effect on salivary pH and plaque formation while fixed treatment with elastic ligature affected the most. Therefore, aligner treatment may be more beneficial for patients with compromised oral hygiene.
Supporting Institution
None
Thanks
We thank to the Department of Orthodontics, Faculty of Dentistry, Marmara University.
References
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- Sawhney R, Sharma R. Microbial colonization on elastomeric ligatures during orthodontic therapeutics: An overview. Turk J Orthod. 2018;31:21-25. DOI: 10.5152/TurkJOrthod.2018.17050.
- Souza RA, Magnani M, Nouer DF, Silva CO, Klein MI, Sallum EA. Periodontal and microbiologic evaluation of 2 methods of archwire ligation: Ligature wires and elastomeric rings. Am J Orthod Dentofacial Orthop. 2008;134:506–512. DOI: 10.1016/j.ajodo.2006.09.067
Year 2024,
, 334 - 340, 28.06.2024
Yousef Y. M. Abu Ebaid
,
Yasemin Bahar Acar
References
- Ren Y, Jongsma MA, Mei L, van der Mei HC, Busscher HJ. Orthodontic treatment with fixed appliances and biofilm formation: A potential public health threat? Clin Oral Investig. 2014;18(7):1711-1718. DOI: 10.1007/s00784-014-1240-3
- Sandic MZ, Popovic B, Carkic J, Nikolic N, Glisic B. Changes in subgingival microflora after placement and removal of fixed orthodontic appliances. Srp Arh Celok Lek. 2014;142(5-6):301-305. DOI: 10.2298/SARH1406301Z
- Turkkahraman H, Sayin MO, Bozkurt FY, Yetkin Z, Kaya S, Önal S. Archwire ligation techniques, microbial colonization, and periodontal status in orthodontically treated patients. Angle Orthod. 2005;75(2):231-236. DOI: 10.1043/00033219(2005)075<0227:ALTMCA>2.0.CO;2
- Anhoury P, Nathanson D, Hughes CV, Socransky S, Feres M, Chou LL. Microbial profile on metallic and ceramic bracket materials. Angle Orthod. 2002;72(4):338-343. DOI: 10.1043/0003-3219(2002)072<0338:MPOMAC>2.0.CO;2
- Tsichlaki A, Chin SY, Pandis N, Fleming PS. How long does treatment with fixed orthodontic appliances last? A systematic review. Am J Orthod Dentofac Orthop. 2016;149:308-318. DOI: 10.1016/j.ajodo.2015.09.020
- Segal GR, Schiffman PH, Tuncay OC. Meta analysis of the treatment-related factors of external apical root resorption. Orthod Craniofac Res. 2004;7(2):71-78. DOI: 10.1111/j.1601-6343.2004.00286.x
- Ogaard B, Rølla G, Arends J. Orthodontic appliances and enamel demineralization. Part 1. Lesion development. Am J Orthod Dentofacial Orthop. 1988;94(1):68-73. DOI: 10.1016/0889-5406(88)90453-2
- Papageorgiou SN, Xavier GM, Cobourne MT, Eliades T. Effect of orthodontic treatment on the subgingival microbiota: A systematic review and meta-analysis. Orthod Craniofac Res. 2018;21(4):175-185. DOI: 10.1111/ocr.12237
- Karkhanechi M, Chow D, Sipkin J, Sherman D, Boylan RJ, Norman RG, Craig RG, Cisneros GJ. Periodontal status of adult patients treated with fixed buccal appliances and removable aligners over one year of active orthodontic therapy. Angle Orthod. 2013;83:146-151. DOI: 10.2319/031212-217.1
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- Azaripour A, Weusmann J, Mahmoodi B, Peppas D, Gerhold-Ay A, Noorden CJ, Willershausen B. Braces versus Invisalign(R): Gingival parameters and patients’ satisfaction during treatment: a cross-sectional study. BMC Oral Health. 2015;15:69-74. DOI: 10.1186/s12903-015-0060-4
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- Levrini L, Mangano A, Montanari P, Margherini S, Caprioglio A, Abbate GM. Periodontal health status in patients treated with the Invisalign® system and fixed orthodontic appliances: A 3 months clinical and microbiological evaluation. Eur J Dent. 2015;9(03):404-410. DOI: 10.4103/1305-7456.163218
- Jiang Q, Li J, Mei L, Du J, Levrini L, Abbate GM, Li H. Periodontal health during orthodontic treatment with clear aligners and fixed appliances: A meta-analysis. J Am Dent Assoc. 2018;149(8):712-720. DOI: 10.1016/j.adaj.2018.04.010
- Miethke RR, Vogt S. A comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed orthodontic appliances. J Orofac Orthop. 2005;66(3):219-229. DOI: 10.1007/s00056-007-0655-8
- Edgar WM. Saliva: its secretion, composition and functions. Br Dent J. 1992;172(8):305-312. DOI: 10.1038/sj.bdj.4807861
- Leone CW, Oppenheim FG. Physical and chemical aspects of saliva as indicators of risk for dental caries in humans. J Dent Educ. 2001; 65:1154–1162. DOI: 10.1002/j.0022-0337.2001.65.10.tb03449.x
- Al-Anezi SA, Harradine NWT; Quantifying plaque during orthodontic treatment: A systematic review. Angle Orthod. 2012;82(4):748–753. DOI: 10.2319/050111-312.1
- Makrygiannakis MA, Kaklamanos EG, Milosevic A, Athanasiou AE. Tooth wear during orthodontic treatment with fixed appliances: A systematic review. J Orthod. 2018;66:1-9. DOI: 10.1080/14653125.2018.151
- Akin M, Tazcan M, Ileri Z, Basciftci FA. Incidence of White Spot lesion during fixed orthodontic treatment. Turk J Orthod. 2013;26:98-102. DOI: 10.13076/j.tjo.2013.26.02_98
- Fadia D, Vandekar M, Vaid N, Doshi V. Plaque accumulation and Streptococcus mutans levels around self-ligating bracket clips and elastomeric modules: A randomized controlled trial. APOS Trends Orthod. 2015;5:97-102. DOI: 10.4103/2321-1407.155830
- Sawhney R, Sharma R, Sharma K. Microbial colonization on elastomeric ligatures during orthodontic therapeutics: An overview. Turk J Orthod. 2018;31:21-25. DOI: 10.5152/TurkJOrthod.2018.17050
- Forsberg CM, Brattström V, Malmberg E, Nord CE. Ligature wires and elastomeric rings: two methods of ligation, and their association with microbial colonization of Streptococcus mutans and lactobacilli. Eur J Orthod. 1991;13(5):416-420. DOI: 10.1093/ejo/13.5.416
- Alessandri Bonetti G, Incerti Parenti S, Garulli G, Gatto MR, Checchi L. Effect of fixed orthodontic appliances on salivary properties. Prog Orthod. 2013;14:1-4. DOI: 10.1186/2196-1042-14-13
- Alshahrani I, Hameed MS, Syed S, Amanullah M, Togoo RA, Kaleem S. Changes in essential salivary parameters in patients undergoing fixed orthodontic treatment: A longitudinal study. Niger J Clin Pract. 2019;22(5):707-712. DOI: 10.4103/njcp.njcp_606_18
- Baliga S, Muglikar S, Kale R. Salivary pH: A diagnostic biomarker. J Indian Soc Periodontol. 2013;17(4):461-465. DOI: 10.4103/0972-124X.118317
- Anu V, Kumar PM, Shivakumar M. Salivary flow rate, pH and buffering capacity in patients undergoing fixed orthodontic treatment - A prospective study. Indian J Dent Res. 2019;30:527-530. DOI:10.4103/ijdr.IJDR_74_16
- Dallel I, Salem IB, Merghni A, Bellalah W, Neffati F, Tobji S, Mastouri M, Amor AB. Influence of orthodontic appliance type on salivary parameters during treatment. Angle Orthod. 2020;90:532-538. DOI: 10.2319/082919-562.1
- Kouvelis G, Papadimitriou A, Merakou K, Doulis I, Karapsias S, Kloukos D. A prospective cohort study assessing the impact of fixed orthodontic appliances on saliva properties and oral microbial flora. Oral Health Prev Dent. 2021;19:67-76. DOI:10.3290/j.ohpd.b898961
- Chang H, Walsh LJ, Freer TJ. The effect of orthodontic treatment on salivary flow, pH, buffer capacity, and levels of mutans streptococci and lacto bacilli. Aust Orthod J. 1999;15(4):229–234. DOI:10.3316/informit.986899452640633
- Al-Haifi HA, Ishaq RA, Al-Hammadi MS. Salivary pH changes under the effect of stainless steel versus elastomeric ligatures in fixed orthodontic patients: A single-center, randomized controlled clinical trial. BMC Oral Health. 2021;21:544-552. DOI: 10.1186/s12903-021-01906-4
- Sawhney R, Sharma R. Microbial colonization on elastomeric ligatures during orthodontic therapeutics: An overview. Turk J Orthod. 2018;31:21-25. DOI: 10.5152/TurkJOrthod.2018.17050.
- Souza RA, Magnani M, Nouer DF, Silva CO, Klein MI, Sallum EA. Periodontal and microbiologic evaluation of 2 methods of archwire ligation: Ligature wires and elastomeric rings. Am J Orthod Dentofacial Orthop. 2008;134:506–512. DOI: 10.1016/j.ajodo.2006.09.067