Buck Tyson, Pellegrini Peter, Sauerwein Rebecca, Leo Michael C, Covell David A, Maier Tom, Machida Curtis A
Department of Orthodontics, Oregon Health & Science University, School of Dentistry, Portland, Oregon 97239, USA.
Orthodontics (Chic.). 2011 Summer;12(2):108-21.
To (1) evaluate the use of adenosine triphosphate (ATP)-driven bioluminescence for quantification of total plaque bacteria in orthodontic patients, (2) compare plaque bacteria amounts at the bracket-tooth interface with use of elastomeric-ligated and self-ligating brackets after 1 year of orthodontic treatment, and (3) analyze formation of white spot lesions by photographic evaluation and laser-light fluorescence (DIAGNOdent).
Thirteen subjects had fixed orthodontic appliances placed where lateral incisors were bonded with either elastomeric-ligated or self-ligating brackets. Plaque bacteria were collected from incisor surfaces after 1 year and quantified using plating methods and ATP-driven bioluminescence. White spot lesions were evaluated by photographic and DIAGNOdent determinations. A 2 x 2 x 2 mixed-design ANOVA was conducted to determine differences in plaque retention between elastomeric-ligated and self-ligating brackets.
ATP-driven bioluminescence values correlated to numbers of total plaque bacteria (r = 0.80). However, unlike findings published in the original pilot study, which described increased plaque retention with elastomeric-ligated brackets at 5 weeks postbonding, there were no significant differences in bacterial numbers or ATP-driven bioluminescence values surrounding the elastomeric-ligated vs self-ligating brackets after 1 year of orthodontic treatment. Based on photographic and DIAGNOdent determinations, white spot lesions were found relatively equally on teeth bonded with either bracket type. DIAGNOdent measurements were found to have moderate sensitivity (0.71) and good specificity (0.88) when compared to white spot lesions determined using photographic evaluation.
ATP-driven bioluminescence can be used as an accurate assessment of total plaque bacteria in orthodontic patients. After 1 year of orthodontic treatment for patients in this pilot study, there appeared to be no differences in retention of plaque bacteria or white spot lesions comparing the bracket types. The use of DIAGNOdent has some limitations, but may prove to be useful to monitor white spot lesions longitudinally.
(1) 评估三磷酸腺苷（ATP）驱动的生物发光法用于定量正畸患者牙菌斑中细菌总数的效果；(2) 比较正畸治疗1年后，使用弹性结扎托槽和自锁托槽时，托槽与牙齿界面处的牙菌斑细菌数量；(3) 通过摄影评估和激光荧光（DIAGNOdent）分析白斑病变的形成情况。
13名受试者接受固定正畸矫治器治疗，侧切牙使用弹性结扎托槽或自锁托槽粘结。1年后从切牙表面收集牙菌斑细菌，采用平板计数法和ATP驱动的生物发光法进行定量分析。通过摄影和DIAGNOdent检测评估白斑病变。采用2×2×2混合设计方差分析确定弹性结扎托槽和自锁托槽在牙菌斑留存方面的差异。
ATP驱动的生物发光值与牙菌斑细菌总数相关（r = 0.80）。然而，与最初的初步研究结果不同，该研究描述了粘结后5周弹性结扎托槽的牙菌斑留存增加，而正畸治疗1年后，弹性结扎托槽和自锁托槽周围的细菌数量或ATP驱动的生物发光值没有显著差异。根据摄影和DIAGNOdent检测，两种托槽粘结的牙齿上白斑病变的发现情况相对相同。与使用摄影评估确定的白斑病变相比，DIAGNOdent测量具有中等灵敏度（0.71）和良好的特异性（0.88）。
ATP驱动的生物发光法可用于准确评估正畸患者牙菌斑中的细菌总数。在本初步研究中，患者正畸治疗1年后，比较不同托槽类型，牙菌斑细菌留存或白斑病变似乎没有差异。DIAGNOdent的使用存在一些局限性，但可能证明对纵向监测白斑病变有用。
