Candida prevalence and oral hygiene due to orthodontic therapy with conventional brackets

Abstract

Background 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. Methods 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. Results 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. R2 = 0.95; p = 0.01709), while average GBI values increased in the noncarriers (adj. R2 = 0.92; p = 0.0256). Conclusions 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.

The Oral Microbiota Changes in Orthodontic Patients and Effects on Oral Health: An Overview

“…In their work, Arslan et al characterized by culture methods Candida species found in 58% of a group of adolescents with fixed orthodontic appliances: C. albicans was predominant (73.8%), followed by C. tropicalis, C. krusei and C. kefyr (7.14%), and C.parapsilosis (4.76%) [ 63 ]. Similar rates were reported by Grzegocka et al [ 65 ] who analyzed Candida spp . from oral rinses and suprangingival plaque in 17 orthodontic subjects (mean age 17 ± 7 years) founding 59% of Candida carriers among them, and a strongly correlation with the massive presence of plaque.…”

Modificaciones del ambiente oral en el tratamiento con ortodoncia fija

“…Topaloglu et al 11 observaron un aumento en los pacientes portadores de Candida en el seguimiento a los 6 meses de tratamiento, el número de pacientes que completaron el estudio fue muy bajo. En concordancia con este estudio, Grzegocka et al 33 describieron que el tratamiento ortodóntico promovió la colonización de las levaduras con variaciones durante el tiempo estudiado, con un bajo número de pacientes portadores. Los resultados de este estudio en coincidencia con los trabajos mencionados reflejarían la habilidad de las bacterias cariogénicas frente a Candida para competir en la supervivencia en la placa bacteriana.…”

Effectiveness of an online application of the health action process approach (HAPA) theory on oral hygiene intervention in young adults with fixed orthodontic appliances: a randomized controlled trial

“…Fixed orthodontic appliances with increasing accuracy and reliability are used in daily clinical practice. However, how to effectively avoid enamel demineralization and maintain good levels of oral hygiene during treatment is still a problem to be overcome [ 1 , 2 ].…”