Abstract
ABSTRACT Background: Oral microbiota has been at the center of cultural attention in recent years. In daily clinical practice, orthodontic appliances may be associated with an increased cariogenic risk and a worsening of preexisting periodontal diseases. Objective: The purpose of this review is to investigate the available evidence regarding the association between orthodontic appliances and changes in the quality and quantity of the oral microbiota. Design: The research included every article published up to October 2017 featuring the keywords ‘Orthodontic appliance* AND (microbiological colonization OR periodontal pathogen* OR Streptococcus mutans OR Lactobacillus spp. OR Candida OR Tannerella forsythia OR Treponema denticola OR Fusobacterium nucleatum OR Aggregatibacter actinomycetemcomitans OR Prevotella intermedia OR Prevotella nigrescens OR Porphyromonas gingivalis)’ and was conducted in the major medical databases. The methodological quality of selected papers was scored using the ‘Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies’ (SBU) method. Results: Orthodontic appliances influence the oral microbiota with an increase in the counts of S. mutans and Lactobacillus spp. and in the percentage of potentially pathogenic gram-negative bacteria. Conclusions: There is moderate/high evidence regarding the association between orthodontic appliances and changes in the oral microbiota. PROSPERO registration number CRD42018091589.
Highlights
Since 1985, the scientific community has been very concerned about the interaction between orthodontic devices and oral bacteria [3,4]; the first studies to analyze the oral microbiota and conventional braces (CB) took place in this period
In 2012, Freitas et al published a systematic review regarding the alteration of the oral microbiota caused by fixed appliances [5]
The Preferred Reporting Items for Reporting Systematic reviews and the Meta Analyses protocol were adopted for this systematic review [6]
Summary
Periodontal health is crucial and requires special attention when performing an orthodontic treatment plan, both in adult and pediatric patients [1]. In 2012, Freitas et al published a systematic review regarding the alteration of the oral microbiota caused by fixed appliances [5]. The authors concluded that ‘The literature revealed moderate evidence that the presence of fixed appliances influences the quantity and quality of oral microbiota’. The authors included papers that analyzed bacteria from appliance surfaces and from oral mucosa, without distinction. Orthodontic appliances may be associated with an increased cariogenic risk and a worsening of preexisting periodontal diseases. Objective: The purpose of this review is to investigate the available evidence regarding the association between orthodontic appliances and changes in the quality and quantity of the oral microbiota
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