The influence of orthodontic fixed appliances on the oral microbiota: A systematic review

Abstract

ObjectiveTo investigate whether there is scientific evidence to support the hypothesis that the presence of orthodontic fixed appliances influences the oral microbiota.MethodsThe search for articles was conducted in PubMed; ISI Web of Knowledge and Ovid databases, including articles published in English until May 17th, 2012. They should report human observational studies presenting the following keywords: "fixed orthodontic appliance" AND "microbiological colonization"; OR "periodontal pathogens"; OR "Streptococcus"; OR "Lactobacillus"; OR "Candida"; OR "Tannerella forsythia"; OR "Treponema denticola"; OR "Fusobacterium nucleatum"; OR "Actimomyces actinomycetemcomitans"; OR "Prevotella intermedia", OR "Prevotella nigrescens"; OR "Porphyromonas gingivalis". Articles were previously selected by title and abstract. Articles that met the inclusion criteria were analyzed and classified as having low, moderate or high methodology quality. A new detailed checklist for quality assessment was developed based on the information required for applicable data extraction for reviews. The study design, sample, follow-up period, collection and microbial analysis methods, statistical treatment, results and discussion were assessed.ResultsThe initial search retrieved 305 articles of which 33 articles were selected by title and abstract. After full-text reading, 8 articles met the inclusion criteria, out of which 4 articles were classified as having low and 4 as moderate methodological quality. The moderate methodological quality studies were included in the systematic review.ConclusionsThe literature revealed moderate evidence that the presence of fixed appliances influences the quantity and quality of oral microbiota.

Changes in oral microbiota due to orthodontic appliances: a systematic review

“…The present systematic review agreed with the conclusions arrived at by Freitas et al [5], which could be extended to any type of orthodontic appliance. The evidence of the selected sample was of medium-high level due to the lack of error of measurements analysis for the collection of material from oral sites.…”

“…Discussions were held to resolve any disagreements; when a resolution could not be found, a third review was consulted. Data extraction from the selected papers was performed independently by two review authors who adopted a template similar to that of Freitas et al [5]. The template was adapted to the necessities of our study and is shown in Table 2 [5].…”

“…Since 1985, the scientific community has been very concerned about the interaction between orthodontic devices and oral bacteria [3,4]; in fact, the first studies to analyze the oral microbiota and conventional braces (CB) took place in this period. In 2012, Freitas et al published a systematic review regarding the alteration of the oral microbiota caused by fixed appliances [5]. The authors concluded that ‘The literature revealed moderate evidence that the presence of fixed appliances influences the quantity and quality of oral microbiota’.…”

Evaluation of the antibacterial activity of a conventional orthodontic composite containing silver/hydroxyapatite nanoparticles

“…Brackets and orthodontic accessories facilitate plaque accumulation and compromise oral hygiene maintenance which lead to an increase in oral bacteria count during orthodontic treatment [2–5]. Despite myriad progresses in orthodontics, fixed orthodontic treatment is still accompanied with a high risk of formation of white spot lesions which are found in more than 50% of orthodontic patients.…”

The effect of orthodontic appliances on oral microflora: A case‐control study

“…Moreover, the most remarkable change occurs 6 months after the beginning of orthodontic treatment and has a significant increase in the prevalence of two cariogenic micro‐organisms, namely S. mutans and Lactobacillus spp. On the one hand, the increase in the rate of S. mutans following the use of orthodontic appliances can be explained by the irregular nature of their surfaces, which promotes the growth of these bacteria . Regardless of moderate levels of evidence, the presence of fixed appliances influences the quantity and quality of the oral flora …”