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Abstract
Nowadays, there is a considerable interest to study the biological and microbiological changes that accompany orthodontic treatment. Growing knowledge on oral microbiota allows, day after day, to identify and characterize the microbial arrangements specifically associated with oral and extra-oral conditions. The aim of the present work is to highlight any further correlations between orthodontic appliances and the qualitative and quantitative modifications of the oral microbiota, such as predisposing factors for the onset of caries, periodontal diseases, and other infections, which can impact the oral and systemic health of the orthodontic patients. When compared with subjects without orthodontic appliances, orthodontic patients reported significant qualitative and quantitative differences in supra- and subgingival plaque during the entire treatment period. Certain components of fixed appliances (mainly bonded molar brackets, ceramic brackets, and elastomeric ligatures) showed high risks of periodontal disease and tooth decay for patients. An unclear prevalence of Candida spp. and the paucity of studies on viruses and protozoas in the oral microbiota of orthodontic patients need to be further investigated. The evidence emerging from this study could guide clinicians in modulating the timing of controls and enhance patient motivation to prevent the formation of mature plaque, thus reducing the risks of oral-plaque-related diseases.
Highlights
IntroductionThe need and prevalence of orthodontic treatments have increased, in developed countries [1], for both therapeutic and aesthetic purposes, and thanks to the development of different orthodontic devices and protocols [2,3,4,5] that meet the needs of every potential patient
Oral Dysbiosis and Related Oral Conditions in General PopulationOver the years, the need and prevalence of orthodontic treatments have increased, in developed countries [1], for both therapeutic and aesthetic purposes, and thanks to the development of different orthodontic devices and protocols [2,3,4,5] that meet the needs of every potential patient
The microbial changes associated to these types of appliances were studied by Ortu et al [53] who evaluated the microbial levels of S. mutans and Lactobacillus spp. in 30 children aged 6–9 years and grouped into 10 subjects treated with rapid palatal expander (RPE), 10 treated with Mc Namara expander, and 10 patients as control
Summary
The need and prevalence of orthodontic treatments have increased, in developed countries [1], for both therapeutic and aesthetic purposes, and thanks to the development of different orthodontic devices and protocols [2,3,4,5] that meet the needs of every potential patient. Gingivitis is a non-destructive inflammation, usually reversible after dental plaque control, while periodontitis, determined by the presence of predisposing factors—genetic and environmental—continues even after the restoration of oral hygiene [8], resulting in the irreversible loss of attachment and teeth due to a perpetuation of local inflammation, initially triggered by periodontopathogen bacteria [9]. Various systematic reviews have confirmed the worsening of clinical parameters indicative of periodontal diseases, such as plaque index, bleeding on probing, attachment loss, and the onset of pockets or gingival recessions, in association with the time and type of orthodontic treatment, reporting varying degrees of reversibility after treatments. Aside from periodontal implications, plaque retention in the presence of orthodontic appliances has been associated with increased susceptibility to caries and is influenced by transient/permanent qualitative and quantitative changes in the oral microbiota, responsible for the onset of oral infections, with systemic effects on well-being [12,13], predisposing orthodontic patients to suffer various pathologies more likely than non-orthodontic patients [14]
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