School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
Orthod Craniofac Res. 2014 May;17(2):115-23. doi: 10.1111/ocr.12037. Epub 2013 Dec 18.
Orthodontic appliances can promote accumulation of dental plaque, with associated enamel decalcification or gingival inflammation. The aim of this study was to examine longer-term microbiological changes during orthodontic treatment with fixed appliances.
Twenty-four orthodontic patients aged 11-14 years undergoing fixed appliance therapy were recruited into the study. Each was randomized for cross-mouth assignment of molar bands and bonded molar tubes to contralateral quadrants of the mouth. All patients received self-ligating brackets, but again using randomization, one upper lateral incisor bracket (left or right) also received an elastomeric ligature. Plaque samples from the molars and upper lateral incisors were obtained at intervals during treatment and up to 1 year after appliance removal. Denaturing gradient gel electrophoresis and 16S rDNA microarray were used to compare plaque microbial fingerprints.
Plaque populations changed within 3 months of commencing treatment at all sites. The greatest differences in plaque composition were seen with self-ligating brackets with an elastomeric ligature. Post-treatment plaque associated with both types of molar attachment contained increased levels of periodontal pathogens Porphyromonas gingivalis, Tannerella forsythia, and Eubacterium nodatum, while Campylobacter rectus, Parvimonas micra, and Actinomyces odontolyticus were also elevated with bonds.
The results suggest that orthodontic treatment may cause sustained changes in plaque microbiotas and that molar bond-associated plaque may have raised disease potential.
正畸矫治器可促进牙菌斑的堆积，从而导致釉质脱矿或牙龈炎症。本研究旨在观察固定矫治器正畸治疗过程中的长期微生物学变化。
本研究招募了 24 名年龄在 11-14 岁之间接受固定矫治器治疗的正畸患者。每位患者随机分配磨牙带环和粘结于磨牙颊面管至口内对侧象限。所有患者均使用自锁托槽，但在上颌侧切牙上，根据随机分配，一个托槽（左侧或右侧）还使用了弹性结扎丝。在治疗期间和矫治器去除后 1 年内的不同时间点，从磨牙和上颌侧切牙上采集菌斑样本。使用变性梯度凝胶电泳和 16S rDNA 微阵列比较菌斑微生物指纹图谱。
在治疗开始后的 3 个月内，所有部位的菌斑菌群均发生了变化。自锁托槽加弹性结扎丝的菌斑组成差异最大。与两种类型的磨牙附件相关的治疗后菌斑中，牙周病病原体牙龈卟啉单胞菌、福赛斯坦纳菌和真杆菌水平升高，而直肠弯曲杆菌、小韦荣球菌和龋齿放线菌也随着粘结物的增加而升高。
结果表明，正畸治疗可能会导致菌斑微生物群的持续变化，并且与带环相关的菌斑可能具有更高的疾病潜力。
