Effect of Orthodontic Appliances on the Oral Environment and Microbiome

Abstract

Orthodontic treatment is an appliance-intensive endeavor, where an array of mechanical devices is used to bring about tooth movement. By virtue of remaining in close proximity to the enamel, gingiva and periodontal ligament intra-orally over a prolonged period of time, orthodontic appliances have a significant impact on the paradental tissues, oral environment and oral microbiome. Orthodontic appliances by acting as anchors for biofilm and plaque formation, accumulate bacteria and other micro-organisms in amounts unfavorable for maintenance of healthy equilibrium. The resulting loss of balance in the oral microbiome causes dysbiosis which manifests clinically as increased enamel demineralization, dental caries and periodontal disease. Mechanical removal of the accumulated plaque by maintaining rigorous oral hygiene has been proven to be the single most important factor to mitigate the harmful effects of dysbiosis. This review investigates how each of the various components of the orthodontic appliances, different types of appliances and unique surface properties of biomaterials have contributory effects at the interface of orthodontic biomaterials and oral biology. The information thus obtained will be critical in instituting the best diagnostic and therapeutic measures at the clinical level. It will also be instrumental in devising improvements and providing new directions for future research in general and precision orthodontics in particular.

Dysbiotic changes of periodontal pathogens in patients wearing conventional and self-ligating orthodontic appliances

“…17 In this regard, dysbiosis generated by fixed orthodontic appliances is responsible for enamel demineralisation but also periodontal disease. 18 The current results revealed that all tested bacteria showed a higher load in SLA when compared with the C group. P. intermedia and F. nucleatum in those wearing CLA, showed a higher load when compared to the C group.…”

Oxidative Stress and Natural Products in Orthodontic Treatment: A Systematic Review

“…This treatment could help reduce the risk of bracket loss and white spot lesions associated with gingival inflammation in at-risk orthodontic patients [ 77 , 100 ]. Microbiological research has found a significant increase in the number of bacteria after the application of fixed orthodontic brackets, which leads to imbalances in the oral environment and increases the risk of diseases, especially tooth decay [ 101 ]. Generally used chlorhexidine can cause unwanted side effects, but, for Kamath et al, aloe vera could be a natural alternative for plaque control and the treatment of gingivitis without the side effects associated with chlorhexidine [ 78 , 102 ].…”

Differences in Saliva pH of Users and Non-users of Fixed Orthodontic Wire in Dental Students (FKG UNPRI)

“…Secretory immunoglobulin A (sIgA), an important part of the salivary defense system, can react to changes in the oral microbiome while orthodontic treatment is going on. [6][7][8][9][10][11] Due to the complex structure of fixed orthodontics, orthodontic wire users should maintain a more hygienic oral environment and teeth. Patients can achieve this by regularly cleansing their teeth and undergoing oral cavity examinations throughout orthodontic treatment.…”