Prevalence of cariogenic streptococci on incisor brackets detected by polymerase chain reaction

Influence of resin modified glass ionomer cement incorporating protein-repellent and antimicrobial agents on supragingival microbiome around brackets: an in-vivo split-mouth 3-month study

Objective

To explore the influence of resin modified glass ionomer cement (RMGIC) adhesives containing protein-repellent and quaternary ammonium salt agents on supragingival microbiome, enamel and gingival health around brackets.

Materials and Methods

Ten patients (21.4 ± 3.5 years) about to receive fixed orthodontics were enrolled in this study. Unilateral upper teeth bonded with RMGIC incorporating 2-Methacryloyloxyethyl phosphorylcholine (MPC) and Dimethylaminohexadecyl methacrylate (DMAHDM) were regarded as experimental group (RMD), while contralateral upper teeth bonded with RMGIC were control group (RMGIC), using a split-mouth design. Supragingival plaque was collected from both groups before treatment (T0), and at 1 month (T1) and 3 months (T2) of treatment. High-throughput sequencing was performed targeting v3-v4 of 16S rRNA gene. Streptococcus mutans and Fusobacterium nucleatum quantification was done by qPCR analysis. Bracket failures, enamel decalcification index (EDI), DIAGNODent scores (Dd), plaque index (PI) and gingival index (GI) were monitored at indicated time points.

Results

Within 3 months, alpha and beta diversity of supragingival plaque had no difference between RMGIC and RMD groups. From T0 to T2, the relative abundance of Streptococcus depleted in RMD but remained steady in RMGIC group. Streptococcus, Prevotella, and Fusobacterium became depleted in RMD, Haemophilus and Capnocytophaga became depleted in RMGIC group but Prevotella enriched. Quantification of Fusbacterium nucleatum and Streptococcus mutans showed significant difference between RMGIC and RMD groups at T2. Teeth bonded with RMD had significant lower plaque index (PI) and DIAGNODent (Dd) score at T2, compared with teeth bonded with RMGIC (p < 0.05). No difference in bracket failure rate was examined between both groups (p > 0.05).

Conclusion

By incorporating MPC and DMAHDM into RMGIC, the material could affect the supragingival microbial composition, inhibit the progress of plaque accumulation as well as the key pathogens S. mutans and F. nucleatum in the early stage of orthodontic treatment.

The Influence of 2-Methacryloyloxyethyl Phosphorylcholine Polymer Materials on Orthodontic Friction and Attachment of Oral Bacteria

There is no clinical evidence of the usage of 2-methacryloyloxyethyl phosphorylcholine (MPC) polymers in dental practice. We performed in vitro studies to determine whether the application of an MPC coating to stainless steel orthodontic wires confers low-friction and antimicrobial properties to these wires. The friction test on MPC-coated wires was performed using a precision universal/tensile tester. MPC polymer was coated on a 50 × 50 mm stainless steel plate, and samples were assessed using an antimicrobial activity test. To verify the effect of MPC polymer-treated wires on experimental tooth movement models in vitro, examinations were performed on typodonts to determine the improvement in tooth movement efficiency. The polymer treatment wire groups demonstrated significantly enhanced tooth movement compared with the untreated wire groups, at both 50 g and 100 g traction forces. The results indicated that MPC coating inhibited the attachment of oral bacteria, such as Streptococcus mutans, on a stainless steel plate. Additionally, the coating seemed to improve the efficiency of tooth movement by reducing the occurrence of friction. The application of an MPC coating onto stainless steel wires, which are used as orthodontic materials, may reduce static friction and bacterial adherence to the oral cavity and improve tooth movement.

The antibacterial effect of silver, zinc-oxide and combination of silver/ zinc oxide nanoparticles coating of orthodontic brackets (an in vitro study)

Background

Preventive measures are essential during the length of orthodontic treatment to reduce the risk of decalcification and white spot lesions formation. With the evolution of procedures that enable coating of the orthodontic brackets using nanoparticles known for their good antibacterial activity, coating the brackets with nanoparticles of silver, zinc oxide and combination of silver and zinc oxide to evaluate their antibacterial effect in comparison to a control group without coating was carried out in this study.

Methods

Four groups of 12 brackets each were included in the study. The coating procedure was carried out using physical vapor deposition. The antibacterial activity was tested on Streptococcus mutans and Lactobacillus Acidophilus using colony forming count. The antibacterial activity was evaluated immediately after coating and later after 3 months.

Results

Brackets coated with combination of silver and zinc oxide nanoparticles had the highest ability on reduction of both Streptococcus mutans and Lactobacillus Acidophilus count followed by silver nanoparticles and then zinc oxide nanoparticles. No significant difference was found between the first and second antibacterial tests.

Conclusion

The silver/zinc oxide nanoparticles coated brackets had the highest antibacterial effect in comparison to silver nanoparticles and zinc oxide nanoparticles individually coated brackets on Streptococcus mutans and Lactobacillus acidophilus, and all types of coatings showed enhanced antibacterial effect in comparison to the uncoated bracket. Coating of orthodontic brackets could be further assessed in clinical application to prevent decalcification.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02263-6.

Self-Crosslinkable Oxidized Alginate-Carboxymethyl Chitosan Hydrogels as an Injectable Cell Carrier for In Vitro Dental Enamel Regeneration

Injectable hydrogels, as carriers, offer great potential to incorporate cells or growth factors for dental tissue regeneration. Notably, the development of injectable hydrogels with appropriate structures and properties has been a challenging task, leaving much to be desired in terms of cytocompatibility, antibacterial and self-healing properties, as well as the ability to support dental stem cell functions. This paper presents our study on the development of a novel self-cross-linkable hydrogel composed of oxidized alginate and carboxymethyl chitosan and its characterization as a cell carrier for dental enamel regeneration in vitro. Oxidized alginate was synthesized with 60% theoretical oxidation degree using periodate oxidation and characterized by Fourier Transform Infrared spectroscopy, proton nuclear magnetic resonance spectroscopy, and Ultraviolet-visible absorption spectroscopy. Then, hydrogels were prepared at three varying weight ratios of oxidized alginate to carboxymethyl chitosan (4:1, 3:1, and 2:1) through Schiff base reactions, which was confirmed by Fourier Transform Infrared spectroscopy. The hydrogels were characterized in terms of gelation time, swelling ratio, structure, injectability, self-healing, antibacterial properties, and in vitro characterization for enamel regeneration. The results demonstrated that, among the three hydrogels examined, the one with the highest ratio of oxidized alginate (i.e., 4:1) had the fastest gelation time and the lowest swelling ability, and that all hydrogels were formed with highly porous structures and were able to be injected through a 20-gauge needle without clogging. The injected hydrogels could be rapidly reformed with the self-healing property. The hydrogels also showed antibacterial properties against two cariogenic bacteria: Streptococcus mutans and Streptococcus sobrinus. For in vitro enamel regeneration, a dental epithelial cell line, HAT-7, was examined, demonstrating a high cell viability in the hydrogels during injection. Furthermore, HAT-7 cells encapsulated in the hydrogels showed alkaline phosphatase production and mineral deposition, as well as maintaining their round morphology, after 14 days of in vitro culture. Taken together, this study has provided evidence that the oxidized alginate-carboxymethyl chitosan hydrogels could be used as an injectable cell carrier for dental enamel tissue engineering applications.

Comparative in vitro study of the cleaning efficacy of AirFloss ultra and I-Prox Sulcus brushes in an orthodontic phantom model

Preventing biofilm-related risks such as gingivitis and white spot lesions during orthodontic treatments is very challenging. The cleaning efficiencies of AirFloss Ultra and I-Prox P sulcus brushes were evaluated using an orthodontic phantom model. After attaching brackets onto black-coated maxillary KaVo teeth, a plaque substitute was applied. The evaluated tooth surfaces were divided into two areas. Cleaning was performed with an AirFloss Ultra with two (A-2) or four (A-4) sprays or an I-Prox P for two (I-2) or four (I-4) seconds. Images before and after cleaning were digitally subtracted, and the percentage of fully cleaned surfaces was determined (Adobe Photoshop CS5, ImageJ). Statistical analysis was performed by ANOVA and post hoc tests with Bonferroni correction (SPSS 25, p < 0.05). The mean values of total cleaning efficacy were 26.87% for I-2, 43.73% for I-4, 34.93%, for A-2 and 56.78% for A-4. The efficacy was significantly higher for A-4 than for A-2, I-4, and I-2. There were significant differences between the four groups. Repeated cleaning led to an improved result. Within the study limitations, the AirFloss Ultra with four sprays proved to be more efficient than the sulcus brush I-Prox P for cleaning.

Effects of Caries Activity on Compositions of Mutans Streptococci in Saliva-Induced Biofilm Formed on Bracket Materials

This study aimed to investigate effects of caries activity on composition of mutans streptococci in saliva-induced biofilms formed on bracket materials. Three bracket materials were used as specimens: ceramic, metal, and plastic. After saliva was collected using a spitting method from caries-active (CA, decayed, missing, filled teeth (DMFT) score ≥ 10) and caries-free (CF, DMFT score = 0) subjects, saliva was mixed with growth media in a proportion of 1:10. The saliva solution was then incubated with each bracket material. After a saliva-induced biofilm was developed on the surface of the bracket material, the amounts of total bacteria and mutans streptococci were determined using real-time polymerase chain reaction. The results showed that biofilms from CA saliva contained more mutans streptococci but less total bacteria than biofilms from CF saliva, regardless of material type. Adhesion of total bacteria to ceramic was higher than to plastic, regardless of caries activity. Mutans streptococci adhered more to ceramic than to metal and plastic in both biofilms from CA and CF saliva, but there was a difference in adhesion between Streptococcus mutans and Streptococcus sobrinus. The amount of S. mutans was higher than that of S. sobrinus in biofilms from CA saliva despite similar amounts of the two strains in biofilms from CF saliva. The stronger adhesion of S. mutans to ceramic than to metal and plastic was more evident in biofilms from CA saliva than in biofilms from CF saliva. This study suggests that caries activity and material type significantly influenced composition of mutans streptococci in biofilms formed on bracket materials.

Synergetic Effect of 2-Methacryloyloxyethyl Phosphorylcholine and Mesoporous Bioactive Glass Nanoparticles on Antibacterial and Anti-Demineralisation Properties in Orthodontic Bonding Agents

2-methacryloyloxyethyl phosphorylcholine (MPC) is known to have antibacterial and protein-repellent effects, whereas mesoporous bioactive glass nanoparticles (MBN) are known to have remineralisation effects. We evaluated the antibacterial and remineralisation effects of mixing MPC and MBN at various ratios with orthodontic bonding agents. MPC and MBN were mixed in the following weight percentages in CharmFil-Flow (CF): CF, 3% MPC, 5% MPC, 3% MPC + 3% MBN, and 3% MPC + 5% MBN. As the content of MPC and MBN increased, the mechanical properties of the resin decreased. At 5% MPC, the mechanical properties decreased significantly with respect to CF (shear bond strength), gelation of MPC occurred, and no significant difference was observed in terms of protein adsorption compared to the control group. Composition 3% MPC + 5% MBN exhibited the lowest protein adsorption because the proportion of hydrophobic resin composite decreased; CF (91.8 ± 4.8 μg/mL), 3% MPC (73.9 ± 2.6 μg/mL), 3% MPC + 3% MBN (69.4 ± 3.6 μg/mL), and 3% MPC + 5% MBN (55.9 ± 1.6 μg/mL). In experiments against S. mutans and E. coli, addition of MPC and MBN resulted in significant antibacterial effects. In another experiment, the anti-demineralisation effect was improved when MPC was added, and when MBN was additionally added, it resulted in a synergetic effect. When MPC and MBN were added at an appropriate ratio to the orthodontic bonding agents, the protein-repellent, antibacterial, and anti-demineralisation effects were improved. This combination could thus be an alternative way of treating white spot lesions.

Real-time polymerase chain reaction quantification of the salivary levels of cariogenic bacteria in patients with orthodontic fixed appliances

Aim

The aim was to investigate the salivary detection frequencies and quantities of caries‐associated bacteria from patients with orthodontic brackets.

Methods

Patients wearing orthodontic brackets (n = 40, mean age = 26 years) and healthy controls without brackets (n = 40, mean age = 17 years) were enrolled in the study. Saliva samples from each patient was collected. After DNA purification, target species comprising streptococci and a Lactobacillus species were detected and quantified from the samples using polymerase chain reaction (PCR) and real‐time quantitative PCR.

Results

Detection frequencies did not differ between the orthodontic patients and the control subjects for any target species except for Streptococcus sobrinus, which showed significantly lower detection rates in orthodontic patients (p < .05). Lactobacillus casei and Streptococcus gordonii were found at the highest detection frequencies with both species being detected in 38 (95%) of the saliva samples of orthodontic patients. Similarly, L. casei and Streptococcus salivarius were the species with highest detection frequencies (35, 87.5%) in the control subjects. Real‐time PCR revealed that Streptococcus mutans and S. salivarius quantities were significantly higher in orthodontic patients than in the control subjects (p < .05).

Conclusions

Application of orthodontic brackets for 12 months leads to increased salivary levels of cariogenic bacteria and may serve as a potential risk factor for caries initiation.

Quantitative analysis of biofilm formation on labial and lingual bracket surfaces

OBJECTIVES

To evaluate and compare the biofilm formation between labial and lingual orthodontic brackets.

MATERIALS AND METHODS

Twenty patients with a mean age of 24 ± 8.8 who had received labial or lingual orthodontic treatment were enrolled in the study. Biofilm formation on 80 brackets was analyzed quantitatively with the Rutherford backscattering detection method. Five micrographs were obtained per bracket with views from the vestibule/lingual, mesial, distal, gingival, and occlusal aspects. Quantitative analysis was carried out with surface analysis software (ImageJ 1.48). Data were analyzed by Mann-Whitney U and Kruskal-Wallis tests (α = 0.05).

RESULTS

Total biofilm formation was 41.56% (min 29.43% to max 48.76%) on lingual brackets and 26.52% (min 21.61% to max 32.71%) on labial brackets. Differences between the two groups were found to be significant. No difference was observed in intraoral location. The biofilm accumulation was mostly located on gingival, mesial, and distal surfaces for both groups.

CONCLUSIONS

The biofilm accumulation on lingual orthodontic therapy was found to be more than labial orthodontic therapy.

Efficacy of a Copper-Calcium-Hydroxide Solution in Reducing Microbial Plaque on Orthodontic Clear Aligners: A Case Report

The aim of this study was to investigate the ability of a copper–calcium–hydroxide-based compound to remove microbial plaque naturally produced onto orthodontic clear aligners. A commercially available dental paste, named Cupral, based on copper–calcium–hydroxide, was used. A healthy volunteer (female, 32 years old), undergoing orthodontic treatment with thermoplastic clear aligners was enrolled. By conventional/confocal microscopy and colony-forming unit (CFU) assay, 2-week used aligners were examined for microbial plaque, prior and following exposure to Cupral. Confocal microscopy revealed abundant plaque irregularly distributed onto the aligner surface. Following Cupral treatment, a drastic decrease occurred in plaque thickness and matrix presence. As assessed by the CFU assay, total microbial load approached 10 ⁹ CFUs/aligner, with slight differences in aerobiosis and anaerobiosis culture conditions; six macroscopically different types of colonies were detected and identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Following Cupral treatment, microbial load dropped to undetectable levels, irrespectively of the conditions considered. Exposure of clear aligners to Cupral results in the elimination of contaminating microorganisms; the antimicrobial activity is retained up to 1.25% concentration. Overall, our data describe a novel use of Cupral, a copper–calcium–hydroxide-based compound, in daily hygiene practices with promising results.

Long-term remineralizing effect of MI Paste Plus on regression of early caries after orthodontic fixed appliance treatment: a 12-month follow-up randomized controlled trial

Background

Casein-phosphopeptide-amorphous-calcium-fluoride-phosphate (CPP-ACFP) can remineralize subsurface lesions. It is the active ingredient of MI-Paste-Plus® (MPP). The long-term remineralization efficacy is unknown.

Objective

To evaluate the long-term effect of MPP versus a placebo paste on remineralization of enamel after fixed orthodontic treatment over a 12-month period.

Design

This trial was designed as a prospective, double-blinded, placebo-controlled RCT.

Methods

Patients with subsurface lesions scheduled for removal of the appliance were included. They applied either MPP or control paste once a day at bedtime for 12 months, complementary to normal oral hygiene.

Main outcome measures

Changes in enamel lesions (primary outcome) were fluorescence loss and lesion area determined by quantitative light-induced fluorescence (QLF). Secondary outcomes were Microbial composition, by conventional plating, and acidogenicity of plaque, by capillary ion analysis (CIA), and lesion changes scored visually on clinical photographs.

Randomization

Participants [age = 15.5 years (SD = 1.6)] were randomly assigned to either the MPP or the control group, as determined by a computer-randomization scheme, created and locked before the start of the study. Participants received neutral-coloured concealed toothpaste tubes marked A or B.

Blinding

The patients and the observers were blinded with respect to the content of tube A or B.

Results

A total of 51 patients were analysed; MPP (n = 25) versus control group (n = 26); data loss (n = 14). There was no significant difference between the groups over time for all the used outcome measures. There was a significant improvement in enamel lesions (fluorescence loss) over time in both groups (P < 0.001 and P < 0.001), with no differences between groups.

Limitations

Being an in vivo study, non-compliance of the subjects could have influenced the result.

Conclusion

The additional use of MPP in patients with subsurface enamel lesions after orthodontic fixed appliance treatment did not improve these lesions during the 1 year following debonding.

Registration

This trial is registered at the medical ethical committee of the VU Medical Centre in Amsterdam (NL.199226.029.07).

Effects of probiotics on salivary Streptecoccus mutans and Lactobacillus levels in orthodontic patients

INTRODUCTION

In this study, we aimed to determine the effect of regular probiotic consumption on microbial colonization in saliva in orthodontic patients and to comparatively evaluate the difference between the systemic consumption of probiotic products and the local application.

METHODS

This study included 3 groups with 15 orthodontic patients in each. The control group included patients who had no probiotic treatment, the subjects in the kefir group consumed 2 × 100 ml of kefir (Atatürk Orman Ciftligi, Ankara, Turkey) per day, and the subjects in the toothpaste group brushed their teeth with toothpaste with probiotic content (GD toothpaste; Dental Asia Manufacturing, Shah Alam, Selangor, Malaysia) twice a day. Samples were collected at 3 times: beginning of the study, 3 weeks later, and 6 weeks later. The salivary flow rate, buffer capacity, and Streptococcus mutans and Lactobacillus levels in the saliva were evaluated. Chair-side kits were used to determine the S mutans and Lactobacillus levels.

RESULTS

A statistically significant decrease was observed in the salivary S mutans and Lactobacillus levels in the kefir and toothpaste groups compared with the control group (P <0.05). A statistically significant increase was observed in the toothpaste group compared with the control and kefir groups in buffer capacity. Changes in the salivary flow rate were not statistically significant.

CONCLUSIONS

The regular use of probiotics during fixed orthodontic treatment reduces the S mutans and Lactobacillus levels in the saliva.

Nanostructured Polymeric Materials with Protein-Repellent and Anti-Caries Properties for Dental Applications

Dental caries is prevalent worldwide. Tooth cavity restorations cost more than $46 billion annually in the United States alone. The current generation of esthetic polymeric restorations have unsatisfactory failure rates. Replacing the failed restorations accounts for 50–70% of all the restorations. This article reviewed developments in producing a new generation of bioactive and therapeutic restorations. This includes: Protein-repellent and anti-caries polymeric dental composites, especially the use of 2-methacryloyloxyethyl phosphorylcholine (MPC) and dimethylaminododecyl methacrylate (DMAHDM); protein-repellent adhesives to greatly reduce biofilm acids; bioactive cements to inhibit tooth lesions; combining protein-repellency with antibacterial nanoparticles of silver; tooth surface coatings containing calcium phosphate nanoparticles for remineralization; therapeutic restorations to suppress periodontal pathogens; and long-term durability of bioactive and therapeutic dental polymers. MPC was chosen due to its strong ability to repel proteins. DMAHDM was selected because it had the most potent antibacterial activity when compared to a series of antibacterial monomers. The new generation of materials possessed potent antibacterial functions against cariogenic and periodontal pathogens, and reduced biofilm colony-forming units by up to 4 logs, provided calcium phosphate ions for remineralization and strengthening of tooth structures, and raised biofilm pH from a cariogenic pH 4.5 to a safe pH 6.5. The new materials achieved a long-term durability that was significantly beyond current commercial control materials. This new generation of bioactive and nanostructured polymers is promising for wide applications to provide therapeutic healing effects and greater longevity for dental restorations.

Comparative Evaluation of Frictional Resistance of Silver-Coated Stainless Steel Wires with Uncoated Stainless Steel Wires: An In vitro Study

Background

Silver is known for its antimicrobial activity. Silver coating effectively reduces Lactobacillus acidophilus and Streptococcus mutans count, thus reducing chances of dental plaque and caries. This silver coating may have effect on frictional property of orthodontic wires.

Aim

The aim of this study is to evaluate and compare frictional resistance of silver-coated and uncoated stainless steel (SS) wires.

Methods

Forty SS wires were divided into four groups of 10 each: Group 1 - 0.017 × 0.025 inch SS wires (silver coated), Group 2 - 0.017 × 0.025 inch SS wires (control), Group 3 - 0.019 × 0.025 inch SS wires (silver coated), and Group 4 - 0.019 × 0.025 inch SS wires (control). Surface modification of wires was carried out by the thermal vacuum evaporation method with silver (10 nm size) using vacuum-coating unit model. The frictional resistances of all forty wires were checked on forty 0.022 × 0.028 inch slot central incisor brackets (SS wires and brackets from American Orthodontics, St Paul, USA) mounted on metal plates using universal testing machine.

Results

There was no significant difference found in frictional resistance between silver-coated and uncoated 0.017 × 0.025 inch SS wires group (P = 0.854). Statistically significant reduction in frictional resistance was observed in 0.019 × 0.025 inch coated SS wires in comparison to uncoated wires (P = 0.032).

Conclusion

Overall silver coating either did not affect the frictional resistance (0.017 × 0.025 inch SS wires) or reduced it (0.019 × 0.025 inch coated SS wires) compared to uncoated wires. Findings suggest that the use of silver-coated SS wires in routine orthodontic practice can be implemented after further in vivo human clinical trials.

Antimicrobial effect, frictional resistance, and surface roughness of stainless steel orthodontic brackets coated with nanofilms of silver and titanium oxide: a preliminary study

Nano-silver and nano-titanium oxide films can be coated over brackets in order to reduce bacterial aggregation and friction. However, their antimicrobial efficacy, surface roughness, and frictional resistance are not assessed before. Fifty-five stainless-steel brackets were divided into 5 groups of 11 brackets each: uncoated brackets, brackets coated with 60 µm silver, 100 µm silver, 60 µm titanium, and 100 µm titanium. Coating was performed using physical vapor deposition method. For friction test, three brackets from each group were randomly selected and tested. For scanning electron microscopy and atomic-force microscopy assessments, one and one brackets were selected from each group. For antibacterial assessment, six brackets were selected from each group. Of them, three were immediately subjected to direct contact with S. mutans. Colonies were counted 3, 6, 24, and 48 h of contact. The other three were stored in water for 3 months. Then were subjected to a similar direct contact test. Results pertaining to both subgroups were combined. Groups were compared statistically. Mean (SD) friction values of the groups 'control, silver-60, silver-100, titanium-60, and titanium-100' were 0.55 ± 0.14, 0.77 ± 0.08, 0.82 ± 0.11, 1.52 ± 0.24, and 1.57 ± 0.41 N, respectively (p = .0004, Kruskal-Wallis). Titanium frictions were significantly greater than control (p < .05), but silver groups were not (p > .05, Dunn). In the uncoated group, colony count increased exponentially within 48 h. The coated groups showed significant reductions in colony count (p < .05, two-way-repeated-measures ANOVA). In conclusions, all four explained coatings reduce surface roughness and bacterial growth. Nano-titanium films are not suitable for friction reduction. Nano-silver results were not conclusive and need future larger studies.

Biofilm formation in Haas palatal expanders with and without use of an antimicrobial agent: an in situ study

Orthodontic appliances causes specific alterations in oral environment, including reduction of pH, increase of dental biofilm and elevation of salivary microbial levels, causing an increased risk for dental caries. This study evaluated, using microbial culture and scanning electron microscopy (SEM), the in situ contamination by mutans streptococci (MS) of different surfaces of Haas palatal expanders with and without use of chlorhexidine gluconate mouthrinses (CHX). Thirty-four patients were randomly assigned to two groups (n = 17/group), using placebo (Group I) and 0.12% CHX (Group II-Periogard^® ) mouthrinses twice a week. After 4 months, appliances were submitted to microbiological processing and after fragments were analyzed by SEM. Mann-Whitney U test (α = 5%) was used to assess differences between groups on the appliances' different surfaces and to compare the contamination on the free and nonfree surfaces of these components. There was no difference (p = 0.999) between groups regarding the number of MS colonies/biofilms on the nonfree surfaces, which showed intense contamination. However, free surfaces of Group II presented less contamination (p < 0.001) than those of Group I in all appliances' components. Results of the microbial culture were confirmed by SEM. Use of 0.12% CHX was effective in reducing the formation of MS colonies/biofilms on free surfaces of Haas expanders, in situ.

Antiadherent and antibacterial properties of stainless steel and NiTi orthodontic wires coated with silver against Lactobacillus acidophilus--an in vitro study

Background

The purpose of the study is to assess the antiadherent and antibacterial properties of surface-modified stainless steel and NiTi orthodontic wires with silver against Lactobacillus acidophilus.

Methods

This study was done on 80 specimens of stainless steel and NiTi orthodontic wires. The specimens were divided into eight test groups. Each group consisted of 10 specimens. Groups containing uncoated wires acted as a control group for their respective experimental group containing coated wires. Surface modification of wires was carried out by the thermal vacuum evaporation method with silver. Wires were then subjected to microbiological tests for assessment of the antiadherent and antibacterial properties of silver coating against L. acidophilus. Mann–Whitney U test was used to analyze the colony-forming units (CFUs) in control and test groups; and Student’s t test (two-tailed, dependent) was used to find the significance of study parameters on a continuous scale within each group.

Results

Orthodontic wires coated with silver showed an antiadherent effect against L. acidophilus compared with uncoated wires. Uncoated stainless steel and NiTi wires respectively showed 35.4 and 20.5 % increase in weight which was statistically significant (P < 0.001), whereas surface-modified wires showed only 4.08 and 4.4 % increase in weight (statistically insignificant P > 0.001). The groups containing surface-modified wires showed statistically significant decrease in the survival rate of L. acidophilus expressed as CFU and as log of colony count when compared to groups containing uncoated wires. It was 836.60 ± 48.97 CFU in the case of uncoated stainless steel whereas it was 220.90 ± 30.73 CFU for silver-modified stainless steel, 748.90 ± 35.64 CFU for uncoated NiTi, and 203.20 ± 41.94 CFU for surface-modified NiTi.

Conclusions

Surface modification of orthodontic wires with silver can be used to prevent the accumulation of dental plaque and the development of dental caries during orthodontic treatment.

Novel protein-repellent and biofilm-repellent orthodontic cement containing 2-methacryloyloxyethyl phosphorylcholine

The objectives of this study were to develop the first protein-repellent resin-modified glass ionomer cement (RMGI) by incorporating 2-methacryloyloxyethyl phosphorylcholine (MPC) for orthodontic applications, and to investigate the MPC effects on protein adsorption, biofilm growth, and enamel bond strength. MPC was incorporated into RMGI at 0% (control), 1.5%, 3%, and 5% by mass. Specimens were stored in water at 37°C for 1 and 30 days. Enamel shear bond strength (SBS) was measured, and the adhesive remnant index (ARI) scores were assessed. Protein adsorption onto the specimens was determined by a micro bicinchoninic acid method. A dental plaque microcosm biofilm model with human saliva as inoculum was used. The results showed that adding 3% of MPC into RMGI did not significantly reduce the SBS (p > 0.1). There was no significant loss in SBS for RMGI containing 3% MPC after water-aging for 30 days, as compared to 1 day (p > 0.1). RMGI with 3% MPC had protein adsorption that was 1/10 that of control. RMGI with 3% MPC greatly reduced the bacterial adhesion, and lactic acid production and colony-forming units of biofilms, while substantially increasing the medium solution pH containing biofilms. The protein-repellent and biofilm-repellent effects were not decreased after water-aging for 30 days. In conclusion, the MPC-containing RMGI is promising to reduce biofilms and white spot lesions without compromising orthodontic bracket-enamel bond strength. The novel protein-repellent method may have applicability to other orthodontic cements, dental composites, adhesives, sealants, and cements to repel proteins and biofilms. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 949-959, 2016.

Comparative three-dimensional analysis of initial biofilm formation on three orthodontic bracket materials

INTRODUCTION

The purpose of the present study was to investigate and compare early biofilm formation on biomaterials, which are being used in contemporary fixed orthodontic treatment.

METHODS

This study comprised 10 healthy volunteers (5 females and 5 males) with a mean age of 27.3 +-3.7 years. Three slabs of different orthodontic materials (stainless steel, gold and ceramic) were placed in randomized order on a splint in the mandibular molar region. Splints were inserted intraorally for 48 h. Then the slabs were removed from the splints and the biofilms were stained with a two color fluorescence assay for bacterial viability (LIVE/DEAD BacLight-Bacterial Viability Kit 7012, Invitrogen, Mount Waverley, Australia). The quantitative biofilm formation was analyzed by using confocal laser scanning microscopy (CLSM).

RESULTS

The biofilm coverage was 32.7 ± 37.7% on stainless steel surfaces, 59.5 ± 40.0% on gold surfaces and 56.8 ± 43.6% on ceramic surfaces. Statistical analysis showed significant differences in biofilm coverage between the tested materials (p=0.033). The Wilcoxon test demonstrated significantly lower biofilm coverage on steel compared to gold (p=0.011). Biofilm height on stainless steel surfaces was 4.0 ± 7.3 μm, on gold surfaces 6.0 ± 6.6 μm and on ceramic 6.5 ± 6.0 μm. The Friedman test revealed no significant differences between the tested materials (p=0.150). Pairwise comparison demonstrated significant differences between stainless steel and gold (p=0.047).

CONCLUSION

Our results indicate that initial biofilm formation seemed to be less on stainless steel surfaces compared with other traditional materials in a short-term observation. Future studies should examine whether there is a difference in long-term biofilm accumulation between stainless steel, gold and ceramic brackets.

Effects of 2 bracket and ligation types on plaque retention: a quantitative microbiologic analysis with real-time polymerase chain reaction

INTRODUCTION

The aim of this study was to evaluate the effects of self-ligating brackets and conventional brackets ligated with stainless steel ligatures on dental plaque retention and microbial flora.

METHODS

Twenty boys (mean age, 14.2 ± 1.5 years) underwent bonding with self-ligating bracket systems and conventional standard edgewise bracket systems ligated with stainless steel ligatures with a split-mouth design. Clinical measurements, including plaque index, probing pocket depth, and bleeding on probing, were obtained before bonding, 1 week after bonding, and 3 months after bonding. Supragingival plaque samples were obtained at baseline and 3 months after bonding for the detection of bacteria. A quantitative analysis for Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, and Lactobacillus acidophilus was performed using real-time polymerase chain reaction. The Mann-Whitney U test and the Hotelling T(2) multivariate test were used for statistical comparisons of the groups.

RESULTS

The numbers of S mutans, S sobrinus, L casei, and L acidophilus were not statistically different between self-ligating brackets and conventional brackets ligated with stainless steel ligatures (P >0.05). The 2 archwire ligation techniques showed no statistically significant differences in plaque index, bleeding on probing, and probing pocket depth values of the bonded teeth (P >0.05). All clinical parameters and the numbers of all microorganisms showed statistically significant increases from baseline to 3 months after bonding in both groups (P <0.001).

CONCLUSIONS

Self-ligating brackets and conventional brackets ligated with stainless steel ligatures do not differ with regard to dental plaque retention.

Three-dimensional analysis of initial biofilm formation on polytetrafluoroethylene in the oral cavity

AIM

There is published evidence that polytetrafluoroethylene (PTFE) exhibits beneficial surface characteristics by means of long-term biofilm accumulation. The purpose of this study was to investigate and compare early biofilm formation on polytetrafluoroethylene, ceramic-reinforced polytetrafluoroethylene and as the control group, stainless steel.

MATERIALS AND METHODS

This study comprised 10 healthy volunteers (5 females and 5 males) with a mean age of 27.3 ± 3.7 years. Three different slabs (two PTFE coatings: one pure and one ceramic-reinforced polytetrafluoroethylene, and stainless steel) were placed in random order on a splint in the mandibular molar region. Intraoral splints were inserted for 48 h. After 48 h, we removed the slabs from the splints and stained the biofilm with a two-color fluorescence assay for bacterial viability (LIVE/DEAD BacLight-Bacterial Viability Kit 7012, Invitrogen, Mount Waverley, Australia). The amount of biofilm accumulation was assessed using confocal laser scanning microscopy (CLSM).

RESULTS

The biofilm surface coverage was 55.8 ± 39.8% on pure PTFE-coated probes, 55.9 ± 35.0% on ceramic-reinforced PTFE-coated probes, and 33.3 ± 37.8% on stainless steel. The differences among the three groups were not significant (p = 0.301). Biofilm depth was 5.6 ± 5.4 μm on pure PTFE-coated probes, 5.2 ± 3.8 μm on ceramic-reinforced PTFE-coated probes, and 2.4 ± 2.9 μm on stainless steel. The Friedman test revealed a significant difference in biofilm depth (p = 0.002). Pairwise comparison of biofilm accumulation yielded a significant difference between pure PTFE and ceramic-reinforced PTFE compared to stainless steel (p = 0.017; p = 0.005).

CONCLUSION

Our results indicate that the beneficial surface characteristics of PTFE coatings by reducing long-term biofilm are not a result of inhibiting initial bacterial adhesion.

Systemic consumption of probiotic curd and use of probiotic toothpaste to reduce Streptococcus mutans in plaque around orthodontic brackets

INTRODUCTION

The objectives of the study were to evaluate and compare the effects of the systemic consumption of probiotic curd and the topical application of probiotic toothpaste on the Streptococcus mutans levels in the plaque of orthodontic patients.

METHODS

The study consisted of 60 orthodontic patients divided into 3 groups of 20 each. Group 1 was the control group. The patients in group 2 were given probiotic curd, and those in group 3 were asked to brush twice daily with probiotic toothpaste (GD toothpaste; Dental Asia Manufacturing, Shah Alam, Selangor, Malaysia). Samples were collected at 2 times: before the study began and after 30 days. Plaque specimens were collected from the labial surfaces immediately surrounding the orthodontic brackets of the maxillary lateral incisors using a 4-pass technique. The presence of S mutans was evaluated using real-time polymerase chain reaction. Statistical analysis was performed, and comparisons were made using a 2-tailed chi-square test for categorical data (P <0.05).

RESULTS

At the end of the study, there were reductions in S mutans concentration in groups 2 and 3 that were statistically significant compared with group 1, but there was no statistically significant difference between groups 2 and 3.

CONCLUSIONS

The consumption of probiotic curd and the use of probiotic toothpaste cause a significant decrease in the S mutans levels in the plaque around brackets in orthodontic patients. Although the probiotic toothpaste was more effective than systemic consumption, this was not statistically significant.

Effect of fixed orthodontic appliances on salivary properties

BACKGROUND

So far, a few studies have tried to investigate the relationship between the placement of fixed orthodontic appliances and the change of nonmicrobial salivary properties, mostly with conflicting outcomes and short-term assessment (up to 6 months from bracket placement). The purpose of this study was to evaluate the salivary flow rate, pH and buffer capacity prior to the beginning of therapy and after 1 year from bracket placement using a simple and commercially available chairside saliva check kit.

METHODS

The study population consisted of 20 healthy patients (mean age, 16.5±4 years) scheduled for fixed orthodontic treatment. Salivary samples were taken just before bracket bonding (T0; baseline assessment) and after 1 year of treatment (T1; half-treatment assessment) using the GC Saliva-Check Kit (GC Corp., Leuven, Belgium).

RESULTS

No statistically significant difference was detected between T0 and T1 for the salivary parameters examined in the present study.

CONCLUSIONS

Under the conditions of this study, the placement of fixed orthodontic appliances did not change the salivary pH, buffer capacity and flow rate after 1 year of treatment if compared with the baseline assessment.

Effect of fluoridated milk on enamel demineralization adjacent to fixed orthodontic appliances

OBJECTIVE

To investigate the effect of daily intake of fluoridated milk on enamel demineralization adjacent to fixed orthodontic brackets assessed with quantitative light-induced fluorescence (QLF).

MATERIALS AND METHODS

Sixty-four healthy adolescents (13-18 years) undergoing orthodontic treatment with fixed appliances were enrolled and randomly allocated to a randomized controlled trial with two parallel groups. The intervention group was instructed to drink one glass of milk (≈ 200 ml) supplemented with fluoride (5 ppm) once daily and the subjects of the control group to drink the same amount of milk without fluoride. The intervention period was 12 weeks and the end-point was mineral gain or loss in enamel, assessed by QLF on two selected sites from each individual. The attrition rate was 12.5% and 112 sites were included in the final evaluation.

RESULTS

There was no statistically significant difference between the groups concerning fluorescence (ΔF) values and lesion area (A mm(2)) at baseline. After 12 weeks, a significant decrease (p < 0.05) in ΔF was registered in the fluoridated milk group and a significant increase in the non-fluoride control group (p < 0.05). The mean reduction in the test group was somewhat lower (14%) than the increase in the control group (18%), but individual variations were evident. Only minor alterations of lesion area were recorded over the 12-week period and no statistically significant differences compared with baseline were found in any of the groups.

CONCLUSION

Daily intake of fluoridated milk may aid remineralization of white spot lesions adjacent to fixed orthodontic appliances.

Molecular detection of Aggregatibacter actinomycetemcomitans on metallic brackets by the checkerboard DNA-DNA hybridization technique

INTRODUCTION

The purpose of this randomized clinical study was to evaluate the presence of the periodontal pathogen Aggregatibacter actinomycetemcomitans on metallic brackets and the effectiveness of a 0.12% chlorhexidine digluconate mouthwash in inhibiting this microorganism.

METHODS

The study involved 35 patients of both sexes having orthodontic treatment with fixed appliances between the ages of 14 and 22 years, randomized into 2 groups: experimental (n = 17) and control (n = 18). Two new metallic brackets were placed on the patients' premolars, and the subjects rinsed with a solution of 0.12% chlorhexidine digluconate or a placebo solution twice a week for 30 days. After that, the brackets were removed and underwent microbiologic analysis with the checkerboard DNA-DNA hybridization technique. Data were analyzed by using the Student t, Fisher exact, and Mann-Whitney tests at the significance level of 5%.

RESULTS

The results showed that A actinomycetemcomitans was present in all brackets from the subjects in the control group vs 83% of the subjects who rinsed with chlorhexidine digluconate (P <0.0001). There were also significantly lower levels of this species in the chlorhexidine digluconate group compared with the control group (P = 0.0003).

CONCLUSIONS

We concluded that 0.12% chlorhexidine digluconate rinsing, twice a week for 30 days during orthodontic treatment, is effective in reducing the presence and levels of A actinomycetemcomitans on metallic brackets.

White-spot lesions and gingivitis microbiotas in orthodontic patients

White-spot lesions (WSL) associated with orthodontic appliances are a cosmetic problem and increase risk for cavities. We characterized the microbiota of WSL, accounting for confounding due to gingivitis. Participants were 60 children with fixed appliances, aged between 10 and 19 yrs, half with WSL. Plaque samples were assayed by a 16S rRNA-based microarray (HOMIM) and by PCR. Mean gingival index was positively associated with WSL (p = 0.018). Taxa associated with WSL by microarray included Granulicatella elegans (p = 0.01), Veillonellaceae sp. HOT 155 (p < 0.01), and Bifidobacterium Cluster 1 (p = 0.11), and by qPCR, Streptococcus mutans (p = 0.008) and Scardovia wiggsiae (p = 0.04) Taxa associated with gingivitis by microarray included: Gemella sanguinis (p = 0.002), Actinomyces sp. HOT 448 (p = 0.003), Prevotella cluster IV (p = 0.021), and Streptococcus sp. HOT 071/070 (p = 0.023); and levels of S. mutans (p = 0.02) and Bifidobacteriaceae (p = 0.012) by qPCR. Species' associations with WSL were minimally changed with adjustment for gingivitis level. Partial least-squares discriminant analysis yielded good discrimination between children with and those without WSL. Granulicatella, Veillonellaceae and Bifidobacteriaceae, in addition to S. mutans and S. wiggsiae, were associated with the presence of WSL in adolescents undergoing orthodontic treatment. Many taxa showed a stronger association with gingivitis than with WSL.

In vitro assessment of photocatalytic titanium oxide surface modified stainless steel orthodontic brackets for antiadherent and antibacterial properties against Lactobacillus acidophilus

OBJECTIVE

To assess the antiadherent and antibacterial properties of surface modified stainless steel orthodontic brackets with photocatalytic titanium oxide (TiO(2)) against Lactobacillus acidophilus.

MATERIALS AND METHODS

This study was done on 120 specimens of stainless steel preadjusted edgewise appliance (PEA) orthodontic brackets. The specimens were divided into four test groups. Each group consisted of 30 specimens. Groups containing uncoated brackets acted as a control group for their respective experimental group containing coated brackets. Surface modification of brackets was carried out by the radiofrequency (RF) magnetron sputtering method with photocatalytic TiO(2). Brackets then were subjected to microbiological tests for assessment of the antiadherent and antibacterial properties of photocatalytic TiO(2) coating against L acidophilus.

RESULTS

Orthodontic brackets coated with photocatalytic TiO(2) showed an antiadherent effect against L acidophilus compared with uncoated brackets. The bacterial mass that was bound to the TiO(2)-coated brackets was less when compared with the uncoated brackets. Furthermore, TiO(2)-coated brackets had a bactericidal effect on L acidophilus, which causes dental caries.

CONCLUSION

Surface modification of orthodontic brackets with photocatalytic TiO(2) can be used to prevent the accumulation of dental plaque and the development of dental caries during orthodontic treatment.

Molecular detection of in-vivo microbial contamination of metallic orthodontic brackets by checkerboard DNA-DNA hybridization

INTRODUCTION

Knowing the microbiota that colonizes orthodontic appliances is important for planning strategies and implementing specific preventive measures during treatment. The purpose of this clinical trial was to evaluate in vivo the contamination of metallic orthodontic brackets with 40 DNA probes for different bacterial species by using the checkerboard DNA-DNA hybridization (CDDH) technique.

METHODS

Eighteen patients, 11 to 29 years of age having fixed orthodontic treatment, were enrolled in the study. Each subject had 2 new metallic brackets bonded to different premolars in a randomized manner. After 30 days, the brackets were removed and processed for analysis by CDDH. Data on bacterial contamination were analyzed descriptively and with the Kruskal-Wallis and Dunn post tests (α = 0.05). Forty microbial species (cariogenic microorganisms, bacteria of the purple, yellow, green, orange complexes, "red complex +Treponema socranskii," and the cluster of Actinomyces) were assessed.

RESULTS

Most bacterial species were present in all subjects, except for Streptococcus constellatus, Campylobacter rectus, Tannerella forsythia, T socranskii, and Lactobacillus acidophillus (94.4%), Propionibacterium acnes I and Eubacterium nodatum (88.9%), and Treponema denticola (77.8%). Among the cariogenic microorganisms, Streptococcus mutans and Streptococcus sobrinus were found in larger numbers than L acidophillus and Lactobacillus casei (P <0.001). The periodontal pathogens of the orange complex were detected in larger numbers than those of the "red complex +T socranskii" (P <0.0001). Among the bacteria not associated with specific pathologies, Veillonella parvula (purple complex) was the most frequently detected strain (P <0.0001). The numbers of yellow and green complex bacteria and the cluster of Actinomyces were similar (P >0.05).

CONCLUSIONS

Metallic brackets in use for 1 month were multi-colonized by several bacterial species, including cariogenic microorganisms and periodontal pathogens, reinforcing the need for meticulous oral hygiene and additional preventive measures to maintain oral health in orthodontic patients.

Antibacterial effect of silver-platinum coating for orthodontic appliances

OBJECTIVE

To develop a hard coating for stainless surfaces based on silver (Ag)-platinum (Pt) alloys.

MATERIALS AND METHODS

Ag-Pt alloys, which have high degree of biocompatibility, excellent resistance to sterilization conditions, and antibacterial properties to different bacteria, are associated with long-term antibacterial efficiency. Approximately 1.03-µm to 2.34-µm-thick coatings, as determined by scanning electron microscopy, were deposited on stainless surfaces by the simultaneous vaporization of both metals (Ag and Pt) in an inert argon atmosphere. The coating was done by physical vapor deposition. Microorganisms and eukaryotic culture cells were grown on these surfaces.

RESULTS

The coatings released sufficient Ag ions when immersed in phosphate-buffered saline and showed significant antimicrobial potency against Streptococcus mutans and Aggregatibacter actinomycetemcomitans strains. At the same time, human gingival fibroblast cells were not adversely affected.

CONCLUSION

Ag-Pt coatings on load-bearing orthodontic bracket surfaces can provide suitable antimicrobial activity during active orthodontic treatment.

Effects of casein phosphopeptide amorphous calcium fluoride phosphate paste on white spot lesions and dental plaque after orthodontic treatment: a 3-month follow-up

The effects of casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) paste vs. control paste on the remineralization of white spot caries lesions and on plaque composition were tested in a double-blind prospective randomized clinical trial. Fifty-four orthodontic patients, with multiple white spot lesions observed upon the removal of fixed appliances, were followed up for 3 months. Subjects were included and randomly assigned to either CPP-ACFP paste or control paste, for use supplementary to their normal oral hygiene. Caries regression was assessed on quantitative light-induced fluorescence (QLF) images captured directly after debonding and 6 and 12 wk thereafter. The total counts and proportions of aciduric bacteria, Streptococcus mutans, and Lactobacillus spp. were measured in plaque samples obtained just before debonding, and 6 and 12 wk afterwards. A significant decrease in fluorescence loss was found with respect to baseline for both groups and no difference was found between groups. The size of the lesion area did not change significantly over time or between the groups. The percentages of aciduric bacteria and of S. mutans decreased from 47.4 to 38.1% and from 9.6 to 6.6%, respectively. No differences were found between groups. We observed no clinical advantage for use of the CPP-ACFP paste supplementary to normal oral hygiene over the time span of 12 wk.

Influence of cigarette smoke condensate on cariogenic and candidal biofilm formation on orthodontic materials

INTRODUCTION

An experimental analysis was made to quantify the adherence rates and the biofilm formation capacity of Streptococcus mutans ATCC25175 and Candida albicans SC5314 on orthodontic material surfaces in the presence of cigarette smoke condensate (CSC).

METHODS

Metal brackets, bands, acrylic resin, and polyurethane elastic rings were coated with stimulated saliva and submitted to adhesion and biofilm formation tests with and without CSC in a dynamic system.

RESULTS

The CSC increased the adhesion of S mutans ATCC25175 to the acquired pellicle (P <0.05) for bands (4.08 times), acrylic resin (2.89 times), and brackets (3.37 times) and reduced it in polyurethane elastic (2.66 times; P <0.05). S mutans ATCC25175 biofilm biomass was increased by CSC only on brackets (1.60 times; P <0.05). In the presence of CSC, the adhesion of C albicans SC5314 increased (P <0.05) on bands (1.81 times), brackets (9.61 times), elastics (29,133 times), and acrylic resin (177 times). Greater formation of C albicans SC5314 biofilm caused by CSC (P <0.05) was observed on acrylic resin (2.13 times) and brackets (2.32 times).

CONCLUSIONS

The results indicated that cigarette tobacco smoke can interfere with the adhesion and biofilm formation of these microorganisms to various orthodontic materials.

Effectiveness of Mouth Washes on Streptococci in Plaque around Orthodontic Appliances

Background and Purpose. Fixed orthodontics may be associated with accumulation of Mutans Streptococci (MS), enamel demineralization, and an increased number of carious lesions, predominantly in sites adjacent to brackets. This study was undertaken to assess the effectiveness of Listerine, Oral-B, and Ortho-kin on the accumulation of MS in plaque around orthodontic brackets. Materials and Methods A double-blind randomized cross-over clinical trial on 25 orthodontic patients, classified into 6 groups was done to assess MS in plaque and saliva with the side specific modified Strip-Mutans technique and the plaque (PI) was measured before and after rinsing using 3 types of commercial mouth-rinses. A washout period (3 weeks) was awaited between using each mouth-rinse and the data was analyzed via Wilcoxon and Kruskal Wallis statistical tests. Results. This study of 25 patients, 5 men and 20 women, with an average age of 19 ± 6/3 assessed the effectiveness of mouth-rinses on MS. Our results showed that Ortho-kin had a better effect than Oral-B and Listerine (P < 0/09). Ortho-kin also had better effects than Oral-B and Listerine on plaque accumulation (P < 0/001). Conclusion. Ortho-kin showed better effects on decreasing MS and PI because it contained chlorhexidine.

Reduction of biofilm on orthodontic brackets with the use of a polytetrafluoroethylene coating

SUMMARY

Treatment with fixed orthodontic appliances can cause enamel demineralization by increased biofilm adhesion. The purpose of the present study was to investigate whether a polytetrafluoroethylene (PTFE) coating reduces biofilm formation on orthodontic brackets. One PTFE-coated bracket and one uncoated stainless steel bracket were bonded symmetrically on the first or second (four maxillary and nine mandibular) primary molars in 13 adolescent patients (five females and eight males, aged 11.2 +/- 2.8 years; four dropouts) for 8 weeks. Quantitative biofilm formation on brackets was analysed with the Rutherford backscattering detection (RBSD) method, a scanning electron microscopy technique. A total of five RBSD micrographs were obtained per bracket with views from the buccal, mesial, distal, cervical, and occlusal aspects. A two-sided paired t-test was used to compare data. A P-value less than 0.05 was considered significant. Total biofilm formation was 4.0 +/- 3.6 per cent of the surface on the PTFE-coated brackets and 22.2 +/- 5.4 per cent on uncoated brackets. Differences between the two groups were statistically significant (P < 0.05). Pairwise comparison of biofilm formation with respect to location (buccal, mesial, distal, cervical, and occlusal) revealed a significantly lower biofilm accumulation on PTFE-coated brackets on all surfaces. The results indicate that PTFE coating of brackets reduces biofilm adhesion to a minimum and might have the potential to reduce iatrogenic side effects, e.g. decalcification during orthodontic treatment with fixed appliances.

Oral bacterial adhesion forces to biomaterial surfaces constituting the bracket-adhesive-enamel junction in orthodontic treatment

Bacterial adhesion to biomaterial surfaces constituting the bracket-adhesive-enamel junction represents a growing problem in orthodontics, because bacteria can adversely affect treatment by causing demineralization of the enamel surface around the brackets. It is important to know the forces with which bacteria adhere to the surfaces of these junction materials, as the strength of these forces will determine how easy it will be to remove the bacteria. We compared the adhesion forces of five initially colonizing and four cariogenic strains of bacteria to an orthodontic adhesive, stainless steel, and enamel, with and without a salivary conditioning film. Adhesion forces were determined using atomic force microscopy and a bacterial probe. In the absence of a salivary conditioning film, the strongest bacterial adhesion forces occurred to the adhesive surface (-2.9 to -6.9 nN), while adhesion forces to the enamel surfaces were lowest (-0.8 to -2.7 nN). In the presence of a salivary conditioning film, adhesion forces were reduced strongly, to less than 1 nN, and the differences between the various materials were reduced. Generally, however, initial colonizers of dental hard surfaces presented stronger adhesion forces to the different materials (-4.7 and -0.6 nN in the absence and presence of a salivary conditioning film, respectively) than cariogenic strains (-1.8 and -0.5 nN).

Reduction of salivary mutans streptococci in orthodontic patients during daily consumption of yoghurt containing probiotic bacteria

Previous studies have suggested that probiotic supplements in dairy products may affect the oral microbial ecology, but the effect in orthodontic patients has not previously been reported. The aim of the present study was to examine whether short-term consumption of fruit yogurt containing probiotic bifidobacteria would affect the levels of salivary mutans streptococci and lactobacilli in patients with fixed orthodontic appliances. A double-blind, randomized crossover study was performed and 24 healthy adolescents (12-16 years) undergoing orthodontic treatment were followed over four periods. During periods 2 and 4 (2 weeks each), the subjects ingested 200 g fruit yogurt containing Bifidobacterium animalis subsp. lactis DN-173010 (2 x 10(8) colony forming units/g) once daily or a control yogurt without viable bacteria. Periods 1 and 3 were run-in and wash-out periods of 1 and 6 weeks, respectively. Salivary mutans streptococci and lactobacilli were enumerated with chair-side kits before and after the yogurt consumption periods. Pre- and post-treatment values within each regimen were compared with a two-tailed marginal homogeneity test for categorical data. A statistically significant reduction of salivary mutans streptococci was recorded after probiotic yogurt consumption (P < 0.05), which was in contrast to the control yogurt. No significant alterations of the salivary lactobacilli counts were observed. Short-term daily consumption of fruit yogurt containing Bifidobacterium animalis subsp. lactis DN-173010 may reduce the levels of mutans streptococci in saliva during orthodontic treatment with fixed appliances.