Zibar Belasic T, Badnjevic M, Zigante M, Mohar Vitezic B, Spalj S, Markova-Car E P
University of Trieste, Department of Medical, Surgical and Health Sciences, Piazza dell'Ospitale 1, Trieste, Italy.
University of Rijeka, Faculty of Dental Medicine, Department of Orthodontics, Kresimirova 40, Rijeka, Croatia.
Arch Oral Biol. 2024 Aug;164:105984. doi: 10.1016/j.archoralbio.2024.105984. Epub 2024 Apr 30.
The effectiveness of supragingival dental biofilm control during orthodontic treatment and changes in the bacterial profile were analyzed.
Sixty-four participants aged 12-22 years (57% female) were included in the study. Participants underwent orthodontic treatment with fixed appliances and were randomly assigned to one of the three groups, which during a period of one month: (I) used chlorhexidine digluconate (CHX), (II) used high concentration of fluoride (F) gel and (III) performed standard oral hygiene. The plaque and gingivitis index, pH of biofilm and white spot lesions (WSL) were assessed. Changes of the bacteria in the biofilm were analyzed by the quantitative polymerase chain reaction RESULTS: Increase in the plaque index, pH of biofilm, and WSL was observed during orthodontic treatment with standard oral hygiene. Large interindividual variability was present, and the effects of one-month use of fluorides and CHX on clinical parameters were not significant. Despite standard hygiene the abundance of studied biofilm bacteria increased - the most Streptoccocus mutans (14.2x) and S. salivarius (3.3x), moderate Veillonella parvula (3x) and the least S. sobrinus (2.3x) and Agregatibacter actinomycetemcomitans (1.9x). The use of CHX reduced S. sobrinus (2.2x) and A. actinomycetemcomitans (1.9x). Fluoride use reduced A. actinomycetemcomitans (1.3x) and S. sobrinus (1.2x). Fluorides better controlled S. mutans than CHX.
Bacterial biomass in supragingival biofilm increased during treatment with metal orthodontic appliances, with greater increase in cariogenic bacteria than periopathogens. Fluoride controlled S. mutans, while CHX S. sobrinus and A. actinomycetemcomitans.
分析正畸治疗期间龈上牙菌斑生物膜控制的有效性以及细菌谱的变化。
本研究纳入了64名年龄在12至22岁之间的参与者（57%为女性）。参与者接受固定矫治器正畸治疗，并被随机分为三组之一，在为期一个月的时间内：（I）使用葡萄糖酸洗必泰（CHX），（II）使用高浓度氟（F）凝胶，（III）进行标准口腔卫生护理。评估菌斑和牙龈炎指数、生物膜pH值和白斑病变（WSL）。通过定量聚合酶链反应分析生物膜中细菌的变化。
在进行标准口腔卫生护理的正畸治疗期间，观察到菌斑指数、生物膜pH值和WSL增加。个体间存在较大差异，使用氟化物和CHX一个月对临床参数的影响不显著。尽管进行了标准卫生护理，但所研究的生物膜细菌数量仍增加——变形链球菌增加最多（14.2倍）和唾液链球菌增加（3.3倍），微小韦荣球菌适度增加（3倍），而远缘链球菌增加最少（2.3倍）和伴放线聚集杆菌增加（1.9倍）。使用CHX可减少远缘链球菌（2.2倍）和伴放线聚集杆菌（1.9倍）。使用氟化物可减少伴放线聚集杆菌（1.3倍）和远缘链球菌（1.2倍）。氟化物比CHX能更好地控制变形链球菌。
在使用金属正畸矫治器治疗期间，龈上生物膜中的细菌生物量增加，致龋菌的增加幅度大于牙周病原菌。氟化物可控制变形链球菌，而CHX可控制远缘链球菌和伴放线聚集杆菌。
