Abstract
Background Orthodontic appliances induce significant changes in the oral microbiome, but this shift in microbial composition has not been well established by the available evidence yet. Objectives To perform a systematic review of existing literature in order to assess the taxonomic microbial changes in orthodontic patients during Fixed Appliance Treatment (FAT) and Clear Aligner Treatment (CAT), using next-generation sequencing (NGS) technique of the bacterial 16S rRNA gene. Search Methods and Selection Criteria. The search for articles was carried out in PubMed, including articles published in English until May 2021. They included every human study report potentially relevant to the review. Data Collection and Analysis. After duplicate study selection and data extraction procedures according to the PICOS scheme, the methodological quality of the included papers was assessed by the Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies (SBU) method. Results The initial search identified 393 articles, 74 of which were selected by title and abstract. After full-text reading, six articles were selected according to inclusion criteria. The evidence quality for all the studies was moderate. Conclusions Orthodontic treatment seems to transiently affect the composition of subgingival microbiome, although not salivary, maintaining a stable microbial diversity. Different results were found in the shift of microbiome between plaque and saliva, depending on the type of orthodontic treatment. This review should be interpreted with some caution because of the number, quality, and heterogeneity of the included studies.
Highlights
In modern society, orthodontic treatment plays a key role in the correction of malocclusion, and in the improvement of aesthetic appearance [1].Fixed Appliance Treatment (FAT) has been the most traditional and effective orthodontic therapy for over a hundred years [2], but in the last decades the demand for a more aesthetic and comfortable treatment has significantly increased [1] and a growing number of patients seek Clear Aligners Treatment (CAT) [3]
International Journal of Dentistry was better for periodontal health than FAT and that Clear Aligner Treatment (CAT) might be recommended for patients at high risk of developing periodontal diseases [1, 6]. e effects of FAT and CAT on the periodontal health reported by previous literature [1, 6,7,8,9,10,11,12] were mainly analyzed through clinical evaluations, based on the more easy observable clinical parameters [13], but it is well known that the promotion of oral health or progression towards periodontal disease is critically influenced by the invisible microbiota [14]
In the long-term period, both Zhao et al [36] and Kado et al [29] concluded that FAT and CAT do not induce significant changes in salivary biodiversity, even if in supragingival plaque a slight bacterial diversity was found after 6 months [29]. e beta diversity indices represent the variation of microbial communities between samples [29]: the stability of microbial community is connected to periodontal health [41]
Summary
Fixed Appliance Treatment (FAT) has been the most traditional and effective orthodontic therapy for over a hundred years [2], but in the last decades the demand for a more aesthetic and comfortable treatment has significantly increased [1] and a growing number of patients seek Clear Aligners Treatment (CAT) [3]. To perform a systematic review of existing literature in order to assess the taxonomic microbial changes in orthodontic patients during Fixed Appliance Treatment (FAT) and Clear Aligner Treatment (CAT), using next-generation sequencing (NGS) technique of the bacterial 16S rRNA gene. After duplicate study selection and data extraction procedures according to the PICOS scheme, the methodological quality of the included papers was assessed by the Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies (SBU) method. Different results were found in the shift of microbiome between plaque and saliva, depending on the type of orthodontic treatment. is review should be interpreted with some caution because of the number, quality, and heterogeneity of the included studies
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