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Assessment of the periodontal health status in patients undergoing orthodontic treatment with fixed or removable appliances. A microbiological and preliminary clinical study

Year 2013, Volume: 16 Issue: 4, 296 - 307, 04.02.2013
https://doi.org/10.7126/cdj.2013.1974

Abstract

Objectives: The use of removable orthodontic appliances minimizes the negative effects on periodontal health allowing patients to carry out oral hygiene without obstacles. The aim of this preliminary study was to evaluate microbiological and clinical changes presented during the first three months of orthodontic therapy in adults with fixed appliances and Invisalign® System (Align Technology, Santa Clara, California).

Materials and Methods: Plaque Index (PI), Probing Depth (PD), Bleeding on probing (BOP), Compliance to oral hygiene and subgingival microbial samples were assessed in 30 patients. Samples were analyzed by real time PCR to detect periodontal pathogens and microbial biofilm mass. A statistical comparison was made over time and amongst the three groups, using Chi-square X2, Odds Ratios (OR), Regression analysis (DOE) and ANOVA.

Results: After 30 and 90 days of treatment there was only one sample with periodontopathic anaerobes found in a patient treated using fixed orthodontic appliances. Direct influence of orthodontic treatment on compliance and less subgingival biofilm mass were found with Invisalign® patients who increased the time dedicated to oral hygiene. A decrease on PD (p=0,002) and BOP (p<0,001) was detected in the Invisalign® group after 90 days of treatment.

Conclusions: In this preliminary study, fixed and removable appliances did not increase the risk for periodontal disease in patients undergoing orthodontic therapy. However, the removable Invisalign® appliances may facilitate oral hygiene procedures, maintaining a lower level of microbial biofilm mass, even with poor oral hygiene compliance, minimizing the negative effects on gingival inflammation.

References

  • 1. Miethke RR, Vogt S. A comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed orthodontic appliances. J Orofac Orthop 2005;66:219-229.
  • 2. Ristic M, Vlahovic Svabic M, Sasic M, Zelic O. Clinical and microbiological effects of fixed orthodontic appliances on periodontal tissues in adolescents. Orthod Craniofac Res 2007;10:187- 195.
  • 3. Zachrisson BU, Alnaes L. Periodontal condition in orthodontically treated and untreated individuals. I. Loss of attachment, gingival pocket depth and clinical crown height. Angle Orthod 1973;43:402-411.
  • 4. Gomes SC, Varela CC, da Veiga SL, Rosing CK, Oppermann RV. Periodontal conditions in subjects following orthodontic therapy. A preliminary study. Euro J Orthod 2007;29:477-481.
  • 5. Van Gastel J, Quirynen M, Teughels W, Carels C, Coucke W. Longitudinal changes in microbiology and clinical periodontal variables after placement of fixed orthodontic appliances. J Periodontol 2008;79:2078-2086.
  • 6. Zachrisson BU, Alnaes L. Periodontal condition in orthodontically treated and untreated individuals. II. Alveolar bone loss: radiographic findings. Angle Orthod 1974;44:48-55.
  • 7. Socransky SS, Haffajee AD. The bacterial etiology of destructive periodontal disease. J Periodontol 1992;63:322-331.
  • 8. Friedman M, Harari D, Rax H. Plaque inhibition by sustained release of chlorhexidine from removable appliances. J Dent Res 1985;064:1319-1321.
  • 9. Pender N. Aspects of oral health in orthodontic patients. Br J Orthod 1986;13:95-103.
  • 10. Petti S, Barbato E, Simonetti D'Arca A. Effect of orthodontic therapy with fixed and removable appliances on oral microbiota: a six-month longitudinal study. New Microbiol 1997;20:55-62.
  • 11. Boyd RL, Miller R, Vlaskalic V. The Invisalign system in adult orthodontics: mild crowding and space closure cases. J Clin Orthod 2000;34:203-212.
  • 12. Miethke RR, Brauner K. A Comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed lingual appliances. J Orofac Orthop 2007;68:223-231.
  • 13. Taylor MG, McGorray SP, Durrett S, Pavlow S, Downey N, Lenk M, et al. Effect of Invisalign aligners on periodontal tissues. J Dent Res 2003;82:1483.
  • 14. Jervøe-Storm PM, Koltzscher M, Falk W, Dörfler A, Jepsen S. Comparison of culture and real-time PCR for detection and quantification of five putative periodontopathogenic bacteria in subgingival plaque samples. J Clin Periodontol 2005;32:778-783.
  • 15. Lau L, Sanz M, Herrera D, Morillo JM, Martin C, Silva C. Quantitative real-time polymerase chain reaction versus culture: A comparison between two methods for the detection and quantification of Actinobacillus actinomycetem- comitans, Porphyromonas gingivalis and Tenerella forsythensis in subgingival plaque samples. J Clin Periodontol 2004;31:1061-1069.
  • 16. Jordan C, LeBlanc DJ. Influences of orthodontic appliances on oral populations of mutans Streptococci. Oral Microbiol Immunol 2002;17:65-71.
  • 17. Naranjo AA, Trivinio ML, Jaramillo A, Betancourth M, Botero JE. Change in the subgingival microbiota and periodontal parameters before and 3 months after bracket placement. Am J Orthod Dentofacial Orthop 2006;130:217-222.
  • 18. Little R. The Irregularity Index: A quantitative score of mandibular anterior alignment. Am J Orthod Dentofacial Orthop 1975;68:554- 563.
  • 19. Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963;21:533-551.
  • 20. Mumghamba EGS, Pitiphat W, Matee M, Simon E, Merchant AT. The usefulness of using Ramfjord teeth in predicting periodontal status of a Tanzanian adult population. J Clin Periodontol 2004;31:16-18.
  • 21. Silness J, Loe H. Peridontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964;22:121-135.
  • 22. Jervøe-Storm PM, Alahdab H, Koltzscher M, Fimmers R, Jepsen S. Comparison of curet and paper point sampling of subgingival bacteria as analyzed by real-time polymerase chain reaction. J Periodontol 2007;78:909-917.
  • 23. Jervøe-Storm PM, Alahdab H, Koltzscher M, Fimmers R, Jepsen S. Quantification of periodontal pathogens by paper point sampling from the coronal and apical aspect of periodontal lesions by real-time PCR. Clin Oral Investig 2010;14: 533-541.
  • 24. Bommarito S, Peyret N, SantaLucia J Jr. Thermodynamic parameters for DNA sequences with dangling ends. Nucleic Acids Res 2000;28:1929- 1934.
  • 25. Orrù G, Marini MF, Ciusa ML, et al. Usefulness of real time PCR for the differentiation and quantification of 652 and JP2 Actinobacillus actinomycetemcomitans genotypes in dental plaque and saliva. BMC Infect Dis 2006; 6:98.
  • 26. Boyd RL, Baumrind S. Periodontal considerations on the use of bonds or bands in molars in adolescents and adults. Angle Orthod 1992;62:117- 126.
  • 27. Huser MC, Baehni PC, Lang R. Effects of orthodontic bands on microbiologic and clinical parameters. Am J Orthod Dentofacial Orthop 1990;97:213-218.
  • 28. Zachrisson BU. A post treatment evaluation of direct bonding in orthodontics. Am J Orthod Dentofacial Orthop 1977;71:173- 189.
  • 29. Van Gastel J, Quirynen M, Teughels W, Coucke W, Carels C. Influence of bracket design on microbial and periodontal parameters in vivo. J Clin Periodontol 2007;34:423-431.
  • 30. Van Gastel J, Quirynen M, Teughels W, Coucke W, Carels C. Longitudinal changes in microbiology and clinical periodontal parameters after removal of fixed orthodontic appliances. Eur J Orthod 2011;33:15-21.
  • 31. Lo Bue, Di Marco R, Milazzo I, Nicolosi D, Calì G, Rossetti B, Blandino G. Microbiological and clinical periodontal effects of fixed orthodontic appliances in pediatric patients. New Microbiol 2008; 31:299-302.
Year 2013, Volume: 16 Issue: 4, 296 - 307, 04.02.2013
https://doi.org/10.7126/cdj.2013.1974

Abstract

References

  • 1. Miethke RR, Vogt S. A comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed orthodontic appliances. J Orofac Orthop 2005;66:219-229.
  • 2. Ristic M, Vlahovic Svabic M, Sasic M, Zelic O. Clinical and microbiological effects of fixed orthodontic appliances on periodontal tissues in adolescents. Orthod Craniofac Res 2007;10:187- 195.
  • 3. Zachrisson BU, Alnaes L. Periodontal condition in orthodontically treated and untreated individuals. I. Loss of attachment, gingival pocket depth and clinical crown height. Angle Orthod 1973;43:402-411.
  • 4. Gomes SC, Varela CC, da Veiga SL, Rosing CK, Oppermann RV. Periodontal conditions in subjects following orthodontic therapy. A preliminary study. Euro J Orthod 2007;29:477-481.
  • 5. Van Gastel J, Quirynen M, Teughels W, Carels C, Coucke W. Longitudinal changes in microbiology and clinical periodontal variables after placement of fixed orthodontic appliances. J Periodontol 2008;79:2078-2086.
  • 6. Zachrisson BU, Alnaes L. Periodontal condition in orthodontically treated and untreated individuals. II. Alveolar bone loss: radiographic findings. Angle Orthod 1974;44:48-55.
  • 7. Socransky SS, Haffajee AD. The bacterial etiology of destructive periodontal disease. J Periodontol 1992;63:322-331.
  • 8. Friedman M, Harari D, Rax H. Plaque inhibition by sustained release of chlorhexidine from removable appliances. J Dent Res 1985;064:1319-1321.
  • 9. Pender N. Aspects of oral health in orthodontic patients. Br J Orthod 1986;13:95-103.
  • 10. Petti S, Barbato E, Simonetti D'Arca A. Effect of orthodontic therapy with fixed and removable appliances on oral microbiota: a six-month longitudinal study. New Microbiol 1997;20:55-62.
  • 11. Boyd RL, Miller R, Vlaskalic V. The Invisalign system in adult orthodontics: mild crowding and space closure cases. J Clin Orthod 2000;34:203-212.
  • 12. Miethke RR, Brauner K. A Comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed lingual appliances. J Orofac Orthop 2007;68:223-231.
  • 13. Taylor MG, McGorray SP, Durrett S, Pavlow S, Downey N, Lenk M, et al. Effect of Invisalign aligners on periodontal tissues. J Dent Res 2003;82:1483.
  • 14. Jervøe-Storm PM, Koltzscher M, Falk W, Dörfler A, Jepsen S. Comparison of culture and real-time PCR for detection and quantification of five putative periodontopathogenic bacteria in subgingival plaque samples. J Clin Periodontol 2005;32:778-783.
  • 15. Lau L, Sanz M, Herrera D, Morillo JM, Martin C, Silva C. Quantitative real-time polymerase chain reaction versus culture: A comparison between two methods for the detection and quantification of Actinobacillus actinomycetem- comitans, Porphyromonas gingivalis and Tenerella forsythensis in subgingival plaque samples. J Clin Periodontol 2004;31:1061-1069.
  • 16. Jordan C, LeBlanc DJ. Influences of orthodontic appliances on oral populations of mutans Streptococci. Oral Microbiol Immunol 2002;17:65-71.
  • 17. Naranjo AA, Trivinio ML, Jaramillo A, Betancourth M, Botero JE. Change in the subgingival microbiota and periodontal parameters before and 3 months after bracket placement. Am J Orthod Dentofacial Orthop 2006;130:217-222.
  • 18. Little R. The Irregularity Index: A quantitative score of mandibular anterior alignment. Am J Orthod Dentofacial Orthop 1975;68:554- 563.
  • 19. Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963;21:533-551.
  • 20. Mumghamba EGS, Pitiphat W, Matee M, Simon E, Merchant AT. The usefulness of using Ramfjord teeth in predicting periodontal status of a Tanzanian adult population. J Clin Periodontol 2004;31:16-18.
  • 21. Silness J, Loe H. Peridontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964;22:121-135.
  • 22. Jervøe-Storm PM, Alahdab H, Koltzscher M, Fimmers R, Jepsen S. Comparison of curet and paper point sampling of subgingival bacteria as analyzed by real-time polymerase chain reaction. J Periodontol 2007;78:909-917.
  • 23. Jervøe-Storm PM, Alahdab H, Koltzscher M, Fimmers R, Jepsen S. Quantification of periodontal pathogens by paper point sampling from the coronal and apical aspect of periodontal lesions by real-time PCR. Clin Oral Investig 2010;14: 533-541.
  • 24. Bommarito S, Peyret N, SantaLucia J Jr. Thermodynamic parameters for DNA sequences with dangling ends. Nucleic Acids Res 2000;28:1929- 1934.
  • 25. Orrù G, Marini MF, Ciusa ML, et al. Usefulness of real time PCR for the differentiation and quantification of 652 and JP2 Actinobacillus actinomycetemcomitans genotypes in dental plaque and saliva. BMC Infect Dis 2006; 6:98.
  • 26. Boyd RL, Baumrind S. Periodontal considerations on the use of bonds or bands in molars in adolescents and adults. Angle Orthod 1992;62:117- 126.
  • 27. Huser MC, Baehni PC, Lang R. Effects of orthodontic bands on microbiologic and clinical parameters. Am J Orthod Dentofacial Orthop 1990;97:213-218.
  • 28. Zachrisson BU. A post treatment evaluation of direct bonding in orthodontics. Am J Orthod Dentofacial Orthop 1977;71:173- 189.
  • 29. Van Gastel J, Quirynen M, Teughels W, Coucke W, Carels C. Influence of bracket design on microbial and periodontal parameters in vivo. J Clin Periodontol 2007;34:423-431.
  • 30. Van Gastel J, Quirynen M, Teughels W, Coucke W, Carels C. Longitudinal changes in microbiology and clinical periodontal parameters after removal of fixed orthodontic appliances. Eur J Orthod 2011;33:15-21.
  • 31. Lo Bue, Di Marco R, Milazzo I, Nicolosi D, Calì G, Rossetti B, Blandino G. Microbiological and clinical periodontal effects of fixed orthodontic appliances in pediatric patients. New Microbiol 2008; 31:299-302.
There are 31 citations in total.

Details

Primary Language English
Journal Section Original Research Articles
Authors

Luca Levrini

Gian Marco Abbate

Federico Migliori

Germano Orru

Salvatore Sauro

Alberto Caprioglio

Publication Date February 4, 2013
Submission Date February 4, 2013
Published in Issue Year 2013Volume: 16 Issue: 4

Cite

EndNote Levrini L, Abbate GM, Migliori F, Orru G, Sauro S, Caprioglio A (November 1, 2013) Assessment of the periodontal health status in patients undergoing orthodontic treatment with fixed or removable appliances. A microbiological and preliminary clinical study. Cumhuriyet Dental Journal 16 4 296–307.

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