BACKGROUND: This pilot study aimed to investigate how fixed orthodontic appliances simultaneously applied on the upper and lower arches affect the oral environment in the medium term. METHODS: The oral status of 30 orthodontic patients was evaluated using the number of decay-missing-filled teeth (DMFT), plaque (PI), and gingival indices (GI) before bonding of fixed orthodontic appliances (T0) and during the therapy (T1). Besides, the gingival crevicular fluid (GCF) and a dental plaque were collected. Samples were analyzed for selected Candida sp. and for 10 selected oral bacteria using mass spectroscopy and multiplex polymerase chain reaction, respectively. RESULTS: In 60% of patients, deterioration of the oral status (demonstrated by the increase in PI) was recorded (p < 0.05). Moreover, the changes in PI correlated with those of GI (p < 0.001). At the T1 time point, the mean representation of Actinomyces sp. in the total prokaryotic DNA in GCF and dental plaque of individual patients increased compared to T0 (p < 0.05). The probability of finding any of the 7 selected periodontal bacteria combined with Candida sp. was 10 times higher in patients in whom PI deteriorated between T0 and T1 (p < 0.01). CONCLUSIONS: Changes in the oral microbial diversity and an increase in PI were observed in the medium term after bonding of orthodontic appliance. Our study highlights the importance of a complex approach in this type of research as the association between clinical characteristics and combined microbial parameters is higher than when evaluated separately.

Clinic of Maxillofacial Surgery Institution Shared with University Hospital Brno Faculty of Medicine Jihlavska 20 625 00 Brno Czech Republic

Clinic of Stomatology Institution Shared with St Anne's University Hospital Faculty of Medicine Masaryk University Pekařská 53 656 91 Brno Czech Republic

Department of Biochemistry Faculty of Science Masaryk University Kamenice 5 625 00 Brno Czech Republic

Department of Microbiology Institution Shared with St Anne's University Hospital and Faculty of Medicine Masaryk University Pekařská 53 656 91 Brno Czech Republic

Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Kamenice 5 625 00 Brno Czech Republic

Margarita Rousi Orthodontic Center Athinon 91 2035 Nicosia Cyprus

RECETOX Faculty of Science Masaryk University Kotlarska 2 Brno Czech Republic

Zobrazit více v PubMed

Proffit WR, Fields HW, Jr, Sarver DM. Contemporary orthodontics. 5. India: Elsevier; 2012.

Dewhirst FE, Chen T, Izard J, Paster BJ, Tanner AC, Yu WH, Lakshmanan A, Wade WG. The human oral microbiome. J Bacteriol. 2010;192(19):5002–5017. doi: 10.1128/JB.00542-10. PubMed DOI PMC

Peterson SN, Snesrud E, Liu J, Ong AC, Kilian M, Schork NJ, Bretz W. The dental plaque microbiome in health and disease. PLoS One. 2013;8(3):e58487. doi: 10.1371/journal.pone.0058487. PubMed DOI PMC

Sheiham A. Dietary effects on dental diseases. Public Health Nutr. 2001;4(2b):569–591. doi: 10.1079/phn2001142. PubMed DOI

Shukla C, Maurya RK, Singh V, Tijare M. Evaluation of changes in Streptococcus mutans colonies in microflora of the Indian population with fixed orthodontics appliances. Dent Res J (Isfahan) 2016;13(4):309. doi: 10.4103/1735-3327.187876. PubMed DOI PMC

Chang H, Walsh LJ, Freer TJ. The effect of orthodontic treatment on salivary flow, pH, buffer capacity, and levels of mutans streptococci and lacto bacilli. Austr Orthod J. 1999;15(4):229–234. PubMed

Contaldo M, Lucchese A, Lajolo C, Rupe C, Di Stasio D, Romano A, Petruzzi M, Serpico R. The oral microbiota changes in orthodontic patients and effects on oral health: an overview. J Clin Med. 2021;10(4). 10.3390/jcm10040780. PubMed PMC

Perkowski K, Baltaza W, Conn DB, Marczyńska-Stolarek M, Chomicz L. Examination of oral biofilm microbiota in patients using fixed orthodontic appliances in order to prevent risk factors for health complications. Ann Agric Environ Med. 2019;26(2):231–235. doi: 10.26444/aaem/105797. PubMed DOI

Klaus K, Eichenauer J, Sprenger R, Ruf S. Oral microbiota carriage in patients with multibracket appliance in relation to the quality of oral hygiene. Head Face Med. 2016;12(1):28. doi: 10.1186/s13005-016-0125-x. PubMed DOI PMC

Maret D, Marchal-Sixou C, Vergnes JN, Hamel O, Georgelin-Gurgel M, Van Der Sluis L, Sixou M. Effect of fixed orthodontic appliances on salivary microbial parameters at 6 months: a controlled observational study. J Appl Oral Sci. 2014;22:38–43. doi: 10.1590/1678-775720130318. PubMed DOI PMC

Grzegocka K, Krzyściak P, Hille-Padalis A, Loster JE, Talaga-Ćwiertnia K, Loster BW. Candida prevalence and oral hygiene due to orthodontic therapy with conventional brackets. BMC Oral Health. 2020;20(1):277. doi: 10.1186/s12903-020-01267-4. PubMed DOI PMC

Lucchese A, Bondemark L, Marcolina M, Manuelli M. Changes in oral microbiota due to orthodontic appliances: a systematic review. J Oral Microbiol. 2018;10(1):1476645. doi: 10.1080/20002297.2018.1476645. PubMed DOI PMC

Paolantonio M, Pedrazzoli V, di Murro C, di Placido G, Picciani C, Catamo G, De Luca M, Piccolomini R. Clinical significance of Actinobacillus actinomycetemcomitans in young individuals during orthodontic treatment: a 3-year longitudinal study. J Clin Periodontol. 1997;24(9):610–617. doi: 10.1111/j.1600-051x.1997.tb00237.x. PubMed DOI

Coronado-Castellote L, Jiménez-Soriano Y. Clinical and microbiological diagnosis of oral candidiasis. J Clin Exp Dent. 2013;5(5):e279. doi: 10.4317/jced.51242. PubMed DOI PMC

Hernández-Solís SE, Rueda-Gordillo F, Flota-Alcocer AD, Agullar-Ayala FJ, Rodríguez-Fernández Mdel S, Lama-González EM. Influence of orthodontic appliances on the occurrence of Candida spp. in the oral cavity. Rev Chilena Infectol. 2016;33(3):293–297. doi: 10.4067/S0716-10182016000300007. PubMed DOI

Tapia CV, Batarce C, Amaro J, Hermosilla G, Rodas PI, Magne F. Microbiological characterisation of the colonisation by Candida sp in patients with orthodontic fixed appliances and evaluation of host responses in saliva. Mycoses. 2019;62(3):247–251. doi: 10.1111/myc.12880. PubMed DOI

Sanz-Orrio-Soler I, Arias de Luxán S, Sheth CC. Oral colonization by Candida species in orthodontic patients before, during and after treatment with fixed appliances. A prospective controlled trial. J Clin Exp Dent. 2020;12(11):e1071–e1077. doi: 10.4317/jced.57565. PubMed DOI PMC

Zheng Y, Li Z, He X. Influence of fixed orthodontic appliances on the change in oral Candida strains among adolescents. J Dent Sci. 2016;11(1):17–22. doi: 10.1016/j.jds.2014.02.001. PubMed DOI PMC

Bergamo AZ, de Oliveira KM, Matsumoto MA, Nascimento CD, Romano FL, da Silva RA, da Silva LA, Nelson-Filho P. Orthodontic appliances did not increase risk of dental caries and periodontal disease under preventive protocol. Angle Orthod. 2019;89(1):25–32. doi: 10.2319/022118-139.1. PubMed DOI PMC

Shukla C, Maurya R, Singh V, Tijare M. Evaluation of role of fixed orthodontics in changing oral ecological flora of opportunistic microbes in children and adolescent. J Indian Soc Pedod Prev Dent. 2017;35(1):34–40. doi: 10.4103/0970-4388.199226. PubMed DOI

Löe H. The gingival index, the plaque index and the retention index systems. J Periodontol. 1967;38(6):610–616. doi: 10.1902/jop.1967.38.6.610. PubMed DOI

Lochman J, Zapletalova M, Poskerova H, Izakovicova Holla L, Borilova Linhartova P. Rapid multiplex real-time PCR method for the detection and quantification of selected cariogenic and periodontal bacteria. Diagnostics. 2020;10(1):8. doi: 10.3390/diagnostics10010008. PubMed DOI PMC

Dean A, Arner T, Sunki G, Friedman R, Lantinga M, Sangam S, Zubieta J, Sullivan K, Brendel K, Gao Z. Epi info™, a database and statistics program for public health professionals. Atlanta: CDC; 2011.

Löe H, Theilade E, Jensen SB. Experimental gingivitis in man. J Periodontol. 1965;36(3):177–187. doi: 10.1902/jop.1965.36.3.177. PubMed DOI

Boyd RL. Longitudinal evaluation of a system for self-monitoring plaque control effectiveness in orthodontic patients. J Clin Periodontol. 1983;10(4):380–388. doi: 10.1111/j.1600-051x.1983.tb01287.x. PubMed DOI

Guo R, Lin Y, Zheng Y, Li W. The microbial changes in subgingival plaques of orthodontic patients: a systematic review and meta-analysis of clinical trials. BMC Oral Health. 2017;17(1):90. doi: 10.1186/s12903-017-0378-1. PubMed DOI PMC

Kouvelis G, Papadimitriou A, Merakou K, Doulis I, Karapsias S, Kloukos D. A prospective cohort study assessing the impact of fixed orthodontic appliances on saliva properties and oral microbial flora. Oral Health Prev Dent. 2021;19(1):67. doi: 10.3290/j.ohpd.b898961. PubMed DOI PMC

Arab S, Nouhzadeh Malekshah S, Abouei Mehrizi E, Ebrahimi Khanghah A, Naseh R, Imani MM. Effect of fixed orthodontic treatment on salivary flow, pH and microbial count. J Dent (Tehran) 2016;13(1):18–22. PubMed PMC

Rodríguez-Rentería M, Márquez-Preciado R, Ortiz-Magdaleno M, Bermeo-Escalona J, Sánchez-Vargas LO. Frequency of pathogenic microorganisms in removable orthodontic appliances and oral mucosa in children. J Clin Pediatr Dent. 2021;45(2):135–139. doi: 10.17796/1053-4625-45.2.11. PubMed DOI

Kim SH, Choi DS, Jang I, Cha BK, Jost-Brinkmann PG, Song JS. Microbiologic changes in subgingival plaque before and during the early period of orthodontic treatment. Angle Orthod. 2012;82(2):254–260. doi: 10.2319/030311-156.1. PubMed DOI PMC

Naranjo AA, Triviño ML, Jaramillo A, Betancourth M, Botero JE. Changes in the subgingival microbiota and periodontal parameters before and 3 months after bracket placement. Am J Orthod Dentofacial Orthop. 2006;130(3):275.e17–275.e22. doi: 10.1016/j.ajodo.2005.10.022. PubMed DOI

Paolantonio M, Festa F, di Placido G, D’Attilio M, Catamo G, Piccolomini R. Site-specific subgingival colonization by Actinobacillus actinomycetemcomitans in orthodontic patients. Am J Orthod Dentofacial Orthop. 1999;115(4):423–428. doi: 10.1016/s0889-5406(99)70263-5. PubMed DOI

Thornberg MJ, Riolo CS, Bayirli B, Riolo ML, Van Tubergen EA, Kulbersh R. Periodontal pathogen levels in adolescents before, during, and after fixed orthodontic appliance therapy. Am J Orthod Dentofacial Orthop. 2009;135(1):95–98. doi: 10.1016/j.ajodo.2007.02.057. PubMed DOI

Mártha K, Lőrinczi L, Bică C, Gyergyay R, Petcu B, Lazăr L. Assessment of periodontopathogens in subgingival biofilm of banded and bonded molars in early phase of fixed orthodontic treatment. Acta Microbiol Immunol Hung. 2016;63(1):103–113. doi: 10.1556/030.63.2016.1.8. PubMed DOI

Živković-Sandić M, Popović B, Čarkić J, Nikolić N, Glišić B. Changes in subgingival microflora after placement and removal of fixed orthodontic appliances. Srp Arh Celok Lek. 2014;142(5–6):301–305. doi: 10.2298/SARH1406301Z. PubMed DOI

Ristic M, Svabic MV, Sasic M, Zelic O. Effects of fixed orthodontic appliances on subgingival microflora. Int J Dent Hyg. 2008;6(2):129–136. doi: 10.1111/j.1601-5037.2008.00283.x. PubMed DOI

Choi DS, Cha BK, Jost-Brinkmann PG, Lee SY, Chang BS, Jang I, Song JS. Microbiologic changes in subgingival plaque after removal of fixed orthodontic appliances. Angle Orthod. 2009;79(6):1149–1155. doi: 10.2319/111808-593R.1. PubMed DOI

Yáñez-Vico RM, Iglesias-Linares A, Ballesta-Mudarra S, Ortiz-Ariza E, Solano-Reina E, Perea EJ. Short-term effect of removal of fixed orthodontic appliances on gingival health and subgingival microbiota: a prospective cohort study. Acta Odontol Scand. 2015;73(7):496–502. doi: 10.3109/00016357.2014.993701. PubMed DOI

Sallum EJ, Nouer DF, Klein MI, Gonçalves RB, Machion L, Sallum AW, Sallum EA. Clinical and microbiologic changes after removal of orthodontic appliances. Am J Orthod Dentofacial Orthop. 2004;126(3):363–366. doi: 10.1016/j.ajodo.2004.04.017. PubMed DOI

Liu H, Sun J, Dong Y, Lu H, Zhou H, Hansen BF, Song X. Periodontal health and relative quantity of subgingival Porphyromonas gingivalis during orthodontic treatment. Angle Orthod. 2011;81(4):609–615. doi: 10.2319/082310-352.1. PubMed DOI PMC

Guo L, Feng Y, Guo HG, Liu BW, Zhang Y. Consequences of orthodontic treatment in malocclusion patients: clinical and microbial effects in adults and children. BMC Oral Health. 2016;16(1):1–7. doi: 10.1186/s12903-016-0308-7. PubMed DOI PMC

Tongue microbiota in relation to the breathing preference in children undergoing orthodontic treatment