Department of Orthodontics, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, ul. Montelupich 4/108, 31-155, Kraków, Poland.
Department of Mycology, Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
BMC Oral Health. 2020 Oct 10;20(1):277. doi: 10.1186/s12903-020-01267-4.
Conventional brackets are often used during orthodontic therapy of patients with malocclusion. The complex construction of such brackets greatly inhibits oral hygiene, which predisposes to increased carriage of microbiota. Orthodontic brackets could act as reservoir of yeast and predispose to oral candidosis. The aim of this study was to assess Candida prevalence and the role of oral hygiene during fixed appliance therapy. A further aim was to characterize the isolated yeasts according to their ability to form biofilms.
Seventeen participants (average age 17 ± 7 years) were monitored by taking oral rinses and elastomeric ligature samples, and by evaluating the approximal plaque index (API) and gingival bleeding index (GBI) before and after placement of the orthodontic conventional brackets for 12 weeks. Isolated yeasts were counted and biofilm formation was evaluated.
One hundred and sixteen samples (67 oral rinses and 49 orthodontic elastomers) were collected. Ten patients (58.8% subjects) were Candida-carriers (two were colonized after bracket placement) and C. albicans was the most common species. The average number of yeasts in the oral cavity showed some fluctuation during the study, but in general had an upward trend (adj. R2 = 0.7967, p = 0.07025). A correlation was found between median number of yeasts and the periodontal indices (API, GBI). The average API values decreased in the Candida-carriers (adj. R = 0.95; p = 0.01709), while average GBI values increased in the noncarriers (adj. R = 0.92; p = 0.0256).
Treatment with orthodontic appliances promotes Candida yeast colonization, which is variable over time in terms of strain and species, with dominance of C. albicans, and without increased biofilm-forming activity. The API value decreases over time in carriers, and the GBI value increases in uncolonized patients, which may have predictive significance for the development of oral candidiasis during orthodontic treatment.
在错颌畸形患者的正畸治疗中，常使用传统托槽。这种托槽的复杂结构极大地抑制了口腔卫生，容易导致微生物携带量增加。正畸托槽可作为酵母的储库，易引发口腔念珠菌病。本研究旨在评估固定矫治器治疗期间念珠菌的流行情况和口腔卫生的作用。进一步的目的是根据其形成生物膜的能力对分离的酵母进行特征描述。
在放置正畸传统托槽前和放置后 12 周，通过采集口腔冲洗液和弹性结扎线样本，评估近中菌斑指数（API）和牙龈出血指数（GBI），监测 17 名参与者（平均年龄 17±7 岁）。对分离的酵母进行计数，并评估生物膜的形成。
共采集 116 个样本（67 个口腔冲洗液和 49 个正畸弹性体）。10 名患者（58.8%的受试者）为念珠菌携带者（2 名在托槽放置后定植），最常见的物种是白念珠菌。在研究过程中，口腔中酵母的平均数量有波动，但总体呈上升趋势（adj. R2=0.7967，p=0.07025）。发现中位酵母数量与牙周指数（API、GBI）之间存在相关性。携带者的平均 API 值降低（adj. R=0.95；p=0.01709），而非携带者的平均 GBI 值升高（adj. R=0.92；p=0.0256）。
正畸矫治器治疗可促进念珠菌酵母定植，定植的菌株和种类随时间变化而变化，以白念珠菌为主，生物膜形成活性无增加。携带者的 API 值随时间降低，未定植患者的 GBI 值升高，这可能对正畸治疗期间口腔念珠菌病的发生具有预测意义。
