A comparison of bacterial adherence on standard orthodontic brackets and titanium miniscrew implants: An in vivo and in vitro study.

摘要

Fixed orthodontic appliances including standard brackets and titanium minscrews have the ability to introduce mechanical plaque (biofilm) traps. These orthodontic appliances impair plaque removal, proper oral hygiene, and gingival health11. The purpose of this study is to determine the bacterial accumulation and subsequent biofilm formation on miniscrews and compare it to that of metal orthodontic brackets, in vivo and in-vitro. Plaque samples were taken from the orthodontic brackets and miniscrews in-vivo. S. mutans, Lactobacillus casei, and P. gingivalis were cultured from these samples. In-vitro, a unique experimental set-up was created in the laboratory. Metal brackets and titanium miniscrew implants were placed into three equal lengths of sterile suction tubing. An equal mix of the three bacterial species were added. The tubes were placed in an anaerobic chamber and cultured at specified time intervals including, one week, two weeks, and three weeks. The colonies were counted and all data analyzed through the use of Tukey-Kramer test and ANOVA. Results: ANOVA found no significant differences for the in-vivo portion of the study. There was an overall increase in all three types of bacteria from the one month to two months with a decrease from months two to three. The bacteria found in greatest amount on all appliance types was S. mutans, followed by Lactobacillus casei, and finally, P. gingivalis, however the differences were not significant. For the in-vitro portion of the study ANOVA found significant differences with regard to appliance type. There was more overall bacterial accumulation on the brackets when compared to the miniscrew. Significant differences were found among bacterial type as well. S. mutans was greatest, followed by L. casei , and P. gingivalis. ANOVA found no significant differences with regard to time period. Orthodontic appliances, including bracket and miniscrews, introduce mechanical plaque traps for patients undergoing treatment. It is up to the orthodontist to provide proper oral hygiene regimens for patients with appliances and to help them to eliminate any possibility of excess plaque/biofilm formation on these appliances.