Abstract
ABSTRACTIntroduction: Although self-ligating brackets presumably provide better hygiene conditions, no consensus has been reached so far. Objective: Therefore, the objective of this study was to evaluate, in an in vitro experimental design, the adherence of Streptococcus mutans (SM) in self-ligating and conventional brackets of different manufacturers and ligature types. Methods: Four commercial brands of maxillary premolar metal brackets were tested (Abzil®; Morelli®; 3M Unitek®; and GAC®). Each one was subdivided into three groups, which varied according to the type of ligature and bracket model (metallic, elastic, and self-ligating), totalizing twelve groups, composed of six brackets each. Previously sterilized brackets were initially immersed in saliva for one hour, and subsequently washed and added in a bacterial suspension, maintained in aerobiosis for 72 hours. The adhered bacteria were then separated and quantified by colony forming units (CFU/mL) counting after 48 hours of growth. The groups were compared by Kruskal-Wallis and Dunn post-hoc tests (p< 0.05). Results: Regardless of the commercial brand, self-ligating brackets had significantly less CFU/mL. However, according to comparisons performed within each commercial brand, only Abzil® self-ligating brackets had significantly lower biofilm adhesion. Among all of the self-ligating models, GAC® brackets presented the highest bacterial adhesion rate. Conclusions: Self-ligating brackets are likely to present lower rates of biofilm adhesion. Particularly, Abzil® and GAC® self-ligating brackets are less likely to accumulate biofilm. Although such results are derived from an in vitro study, practitioners might acknowledge findings concerning bacterial adhesion as one of the relevant features to be considered during bracket selection.
Highlights
Self-ligating brackets presumably provide better hygiene conditions, no consensus has been reached so far
According to comparisons performed within each commercial brand, only Abzil® self-ligating brackets had significantly lower biofilm adhesion
Comparative analyzes between types of bracket / ligatures, regardless of the brand are depicted in the Figure 3
Summary
Self-ligating brackets presumably provide better hygiene conditions, no consensus has been reached so far. Objective: the objective of this study was to evaluate, in an in vitro experimental design, the adherence of Streptococcus mutans (SM) in self-ligating and conventional brackets of different manufacturers and ligature types. Results: Regardless of the commercial brand, self-ligating brackets had significantly less CFU/mL. According to comparisons performed within each commercial brand, only Abzil® self-ligating brackets had significantly lower biofilm adhesion. Among all of the self-ligating models, GAC® brackets presented the highest bacterial adhesion rate. Conclusions: Self-ligating brackets are likely to present lower rates of biofilm adhesion. Abzil® and GAC® self-ligating brackets are less likely to accumulate biofilm. Such results are derived from an in vitro study, practitioners might acknowledge findings concerning bacterial adhesion as one of the relevant features to be considered during bracket selection. Even though orthodontic treatment brings important positive clinical and psychological effects,[1,2,3,4] it is still likely to cause side effects, such as external root resorption and vertical reduction of the alveolar bone crest.[5,6,7,8,9] In addition, orthodontic full-fixed appliances may complicate oral hygiene,[10,11] resulting in significant biofilm accumulation around the brackets bases.[11,12,13,14] As a consequence, this accumulation can lead to negative alterations, such as gingivitis,[15,16,17] enamel demineralization, including the formation of white spots lesions.[15,20,21] orthodontic patients’ installed biofilm profile may be negatively altered,[22,23,24,25,26] with simultaneous increase and deterioration of the microbiota quality[25].
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