EVALUATION OF MICROBIAL FLORA IN PATIENTS WITH GINGIVAL ENLARGEMENT DURING THE TREATMENT AND SURFACE CHEMISTRY OF FIXED ORTHODONTIC APPLIANCE ARCHWIRE
Keywords:
biocompatible stainless steel, AISI 304L, archwires, periodontopathogenic bacteria, gingival enlargement, fixed orthodontic appliance, X-ray photoelectron spectroscopy (XPS)
Abstract
Gingival enlargement is a common complication of treatment with a fixed orthodontic appliance, biocompatible stainless-steel archwires AISI 304L (SS). Due to the retention areas, dental plaque accumulation is increased, which results in anaerobic conditions, favourable for periodontopathogenic bacteria. Therefore, it is reasonable to assume that periodontopathogenic bacteria can be found in patients with fixed orthodontic appliances. Organic deposits on the surface of archwires were analyzed. Twenty-one patients with fixed orthodontic appliances and gingival enlargement in the upper dental arch were included in the study. For a determination of the periodontopathogenic bacteria Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola the molecular microbiological method GenoType Test System was used. For the surface analysis of new and in-vivo exposed SS archwires X-ray Photoelectron Spectroscopy was used. The average probing depth at the baseline was 3.76±0.85 mm. Three types of periodontopathogenic bacteria, namely A. actinomycetemcomitans, T. forsythia and T. denticola, were found to be present. The thickeness of the thin oxide film on new archwires was 8 nm, while organic deposits on the in-vivo exposed archwires was estimated to 60–80 nm. Anaerobic periodontopathogenic bacteria can be found in patients with fixed orthodontic appliances. Therefore, special care is recommended during this kind of treatment.
References
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15 I. D. Lindel, C. Elter, W. Heuer, T. Heidenblut, M. Stiesch, R. Schwestka-Polly, A. P. Demling, Comparative analysis of long-term biofilm formation on metal and ceramic brackets, Angle Orthod, 81 2011/05/06, (2011), 907–14, doi:10.2319/102210-616.1
16 J. R. Landis, G. G. Koch, The measurement of observer agreement for categorical data, Biometrics, 33 1977/03/01 ed (1977), 159–74
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18 J. J. Zambon, L. A. Christersson, J. Slots, Actinobacillus actino¬mycetemcomitans in human periodontal disease. Prevalence in patient groups and distribution of biotypes and serotypes within families, J Periodontol, 54 (1983), 707–11, doi:10.1902/jop.1983. 54.12.707
19 L. A. Christersson, Actinobacillus actinomycetemcomitans and localized juvenile periodontitis. Clinical, microbiologic and histologic studies, Swed Dent J Suppl, 90 (1993), 1–46
20 S. A. Alexander, Effects of orthodontic attachments on the gingival health of permanent second molars, Am J Orthod Dentofacial Orthop, 100 (1991), 337–40, doi:10.1016/0889-5406(91)70071-4
21 I. Darby, M. Curtis, Microbiology of periodontal disease in children and young adults, Periodontol 2000, 26 (2001), 33–53, doi:10.1034/j.1600-0757.2001.2260103.x
22 M. Paolantonio, V. Pedrazzoli, C. di Murro, G. di Placido, C. Picciani, G. Catamo, M. De Luca, R. Piaccolomini, Clinical significance of Actinobacillus actinomycetemcomitans in young individuals during orthodontic treatment. A 3-year longitudinal study, J Clin Periodontol, 24 (1997), 610–7, doi:10.1111/j.1600-051x.1997. tb00237.x
23 M. Ristic, M. Vlahovic Svabic, M. Sasic, O. Zelic, Clinical and microbiological effects of fixed orthodontic appliances on periodontal tissues in adolescents, Orthod Craniofac Res, 10 (2007), 187–95, doi:10.1111/j.1601-6343.2007.00396.x
24 C. Nonnenmacher, R. Mutters, L. F. de Jacoby, Microbiological characteristics of subgingival microbiota in adult periodontitis, localized juvenile periodontitis and rapidly progressive periodontitis subjects, Clin Microbiol Infect, 7 (2001), 213–7, doi:10.1046/j.1469-¬0691.2001.00210.x
25 R. Teanpaisan, C. W. Douglas, T. F. Walsh, Characterisation of black-pigmented anaerobes isolated from diseased and healthy periodontal sites, J Periodontal Res, 30 (1995), 245–51, doi:10.1111/ j.1600-0765.1995.tb02129.x
26 R. L. Boyd, Longitudinal evaluation of a system for self-monitoring plaque control effectiveness in orthodontic patients, J Clin Periodontol, 10 1983/07/01 ed (1983), 380–8, doi:10.1111/j.1600-¬051x.1983.tb01287.x
27 P. Zhu, H. Lin, Y. Han, Y. Lin, Y. Xu, Z. Zhang, A computational fluid dynamic analysis of peri-bracket salivary flow influencing the microbial and periodontal parameters, PLoS One, 8 (2013), e62242, doi:10.1371/journal.pone.0062242
28 B. Rowshani, M. F. Timmerman, U. Van der Velden, Plaque development in relation to the periodontal condition and bacterial load of the saliva, J Clin Periodontol, 31 (2004), 214–8, doi:10.1111/j.0303-¬6979.2004.00468.x
29 P. Ramberg, P. Axelsson, J. Lindhe, Plaque formation at healthy and inflamed gingival sites in young individuals, J Clin Periodontol, 22 (1995), 85–8, doi:10.1111/j.1600-051x.1995.tb01775.x
30 I. S. Marques, A. M. Araujo, J. A. Gurgel, D. Normando, Debris, roughness and friction of stainless steel archwires following clinical use, Angle Orthod, 80 (2010), 521–7, doi:10.2319/081109-457.1
31 R. C. Araujo, L. M. Bichara, A. M. Araujo, D. Normando, Debris and friction of self-ligating and conventional orthodontic brackets after clinical use, Angle Orthod, 85 (2015), 673–7, doi:10.2319/012914-80.1
32 W. E. Moore, L. V. Holdeman, R. M. Smibert, D. E. Hash, J. A. Burmeister, R. R. Ranney, Bacteriology of severe periodontitis in young adult humans, Infect Immun, 38 (1982), 1137–48
33 Y. Yoshida, N. Suzuki, Y. Nakano, K. Shibuya, Y. Ogawa, T. Koga, Distribution of Actinobacillus actinomycetemcomitans serotypes and Porphyromonas gingivalis in Japanese adults, Oral Microbiol Immunol, 18 (2003), 135–9, doi:10.1034/j.1399-302x.2003.00034.x
34 M. P. Riggio, T. W. Macfarlane, D. Mackenzie, A. Lennon, A. J. Smith, D. Kinane, Comparison of polymerase chain reaction and culture methods for detection of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in subgingival plaque samples, J Periodontal Res, 31 (1996), 496–501, doi:10.1111/j.1600--0765.1996.tb01415.x
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36 J. Lindhe, N. P. Lang, T. Karring, Clinical Periodontology and Implant Dentistry, Oxford, Blackwell Munnksgard, 6th ed 2011
37 B. K. Wong, N. R. McGregor, H. L. Butt, R. Knight, L. Y. Liu, I. B. Darby, Association of clinical parameters with periodontal bacterial haemolytic activity, J Clin Periodontol, 43 (2016), 503–11, doi:10.1111/jcpe.12554
38 A. J. Ireland, V. Soro, S. V. Sprague, N. W. Harradine, C. Day, S. Al-Anezi, H. F. Jenkinson, M. Sherriff, D. Dymock, J. R. Sandy, The effects of different orthodontic appliances upon microbial communities, Orthod Craniofac Res, 17 (2014), 115–23, doi:10.1111/ ocr.12037
39 M. J. Thornberg, C. S. Riolo, B. Bayirli, M. L. Riolo, E. A. Van Tubergen, R. Kulbersh, Periodontal pathogen levels in adolescents before, during, and after fixed orthodontic appliance therapy, Am J Orthod Dentofacial Orthop, 135 (2009), 95–8, doi:10.1016/ j.ajodo.2007.02.057
40 G. Perinetti, M. Paolantonio, E. Serra, D. D’Archivio, S. D’Ercole, F. Festa, G. Spoto, Longitudinal monitoring of subgingival colonization by Actinobacillus actinomycetemcomitans, and crevicular alkaline phosphatase and aspartate aminotransferase activities around orthodontically treated teeth, J Clin Periodontol, 31 (2004), 60–7, doi:10.1111/j.0303-6979.2004.00450.x
41 J. F. Moulder, W. F. Stickle, P. E. Sobol, K. D. Bomben, Handbook of X-Ray Photoelectron Spectroscopy, Physical Electronics Inc., Eden Prairie, Minnesota, USA, (1995)
42 U. Mezeg, Evaluation of the surface characteristics of orthodontic brackets, archwires and their intraoral degradation processes, Doctoral thesis, Medical faculty, University, 2018, Ljubljana
2 J. Miranda, L. Brunet, P. Roset, M. Farre, C. Mendieta, Reliability of two measurement indices for gingival enlargement, J Periodontal Res, 47 (2012), 776–82, doi:10.1111/j.1600-0765.2012.01495.x
3 L. Brunet, J. Miranda, M. Farre, L. Berini, C. Mendieta, Gingival enlargement induced by drugs, Drug Saf, 15 1996/09/01,(1996), 219–31, doi:10.2165/00002018-199615030-00007
4 J. Lindhe, E. Westfelt, S. Nyman, S. S. Socransky, A. D. Haffajee, Long-term effect of surgical/non-surgical treatment of periodontal disease, J Clin Periodontol, 11 (1984), 448–58, doi:10.1111/j.1600-¬051x.1984.tb01344.x
5 U. Mezeg, J. Primozic, Influence of long-term in vivo exposure, debris accumulation and archwire material on friction force among different types of brackets and archwires couples, Eur J Orthod, 39 (2017), 673–679, doi:10.1093/ejo/cjx007
6 E. J. Sallum, D. F. Nouer, M. I. Klein, R. B. Gonçalves, L. Machion, A. Wilson Sallum, E. A. Sallum, Clinical and microbiologic changes after removal of orthodontic appliances, Am J Orthod Dentofacial Orthop, 126 (2004), 363–6, doi:10.1016/S0889540604004342
7 J. van Gastel, M. Quirynen, W. Teughels, W. Coucke, C. Carels, Longitudinal changes in microbiology and clinical periodontal variables after placement of fixed orthodontic appliances, J Periodontol, 79 (2008), 2078–86, doi:10.1902/jop.2008.080153
8 J. S. Kloehn, J. S. Pfeifer, The effect of orthodontic treatment on the periodontium, Angle Orthod, 44 (1974), 127–34, doi:10.1043/0003--3219(1974)044<0127:TEOOTO>2.0.CO;2
9 I. A. Gubina M., Medicinska bakteriologija z imunologijo in mikologijo, Ljubljana, Medicinski razgledi, 2002
10 J. Lindhe, N. P. Lang, T. Karring, Clinical Periodontology and Implant Dentistry, Oxford, Blackwell Munksgaard, 5th ed 2008
11 N. E. Atack, J. R. Sandy, M. Addy, Periodontal and microbiological changes associated with the placement of orthodontic appliances. A review, J Periodontol, 67 (1996), 78–85, doi:10.1902/jop.1996. 67.2.78
12 J. A. Chapman, W. E. Roberts, G. J. Eckert, K. S. Kula, C. Gonzalez-Cabezas, Risk factors for incidence and severity of white spot lesions during treatment with fixed orthodontic appliances, Am J Orthod Dentofacial Orthop, 138 (2010), 188–94, doi:10.1016/ j.ajodo.2008.10.019
13 U. K. Gursoy, O. Sokucu, V. J. Uitto, A. Aydin, S. Demirer, H. Toker, O. Erdem, A. Sayal, The role of nickel accumulation and epithelial cell proliferation in orthodontic treatment-induced gingival overgrowth, Eur J Orthod, 29 (2007), 555–8, doi:10.1093/ejo/cjm074
14 M. Quirynen, C. Dekeyser, D. van Steenberghe, The influence of gingival inflammation, tooth type, and timing on the rate of plaque formation, J Periodontol, 62 (1991), 219–22, doi:10.1902/jop.1991. 62.3.219
15 I. D. Lindel, C. Elter, W. Heuer, T. Heidenblut, M. Stiesch, R. Schwestka-Polly, A. P. Demling, Comparative analysis of long-term biofilm formation on metal and ceramic brackets, Angle Orthod, 81 2011/05/06, (2011), 907–14, doi:10.2319/102210-616.1
16 J. R. Landis, G. G. Koch, The measurement of observer agreement for categorical data, Biometrics, 33 1977/03/01 ed (1977), 159–74
17 J. Slots, The predominant cultivable organisms in juvenile periodontitis, Scand J Dent Res, 84 (1976), 1–10, doi:10.1111/ j.1600-¬0722.1976.tb00454.x
18 J. J. Zambon, L. A. Christersson, J. Slots, Actinobacillus actino¬mycetemcomitans in human periodontal disease. Prevalence in patient groups and distribution of biotypes and serotypes within families, J Periodontol, 54 (1983), 707–11, doi:10.1902/jop.1983. 54.12.707
19 L. A. Christersson, Actinobacillus actinomycetemcomitans and localized juvenile periodontitis. Clinical, microbiologic and histologic studies, Swed Dent J Suppl, 90 (1993), 1–46
20 S. A. Alexander, Effects of orthodontic attachments on the gingival health of permanent second molars, Am J Orthod Dentofacial Orthop, 100 (1991), 337–40, doi:10.1016/0889-5406(91)70071-4
21 I. Darby, M. Curtis, Microbiology of periodontal disease in children and young adults, Periodontol 2000, 26 (2001), 33–53, doi:10.1034/j.1600-0757.2001.2260103.x
22 M. Paolantonio, V. Pedrazzoli, C. di Murro, G. di Placido, C. Picciani, G. Catamo, M. De Luca, R. Piaccolomini, Clinical significance of Actinobacillus actinomycetemcomitans in young individuals during orthodontic treatment. A 3-year longitudinal study, J Clin Periodontol, 24 (1997), 610–7, doi:10.1111/j.1600-051x.1997. tb00237.x
23 M. Ristic, M. Vlahovic Svabic, M. Sasic, O. Zelic, Clinical and microbiological effects of fixed orthodontic appliances on periodontal tissues in adolescents, Orthod Craniofac Res, 10 (2007), 187–95, doi:10.1111/j.1601-6343.2007.00396.x
24 C. Nonnenmacher, R. Mutters, L. F. de Jacoby, Microbiological characteristics of subgingival microbiota in adult periodontitis, localized juvenile periodontitis and rapidly progressive periodontitis subjects, Clin Microbiol Infect, 7 (2001), 213–7, doi:10.1046/j.1469-¬0691.2001.00210.x
25 R. Teanpaisan, C. W. Douglas, T. F. Walsh, Characterisation of black-pigmented anaerobes isolated from diseased and healthy periodontal sites, J Periodontal Res, 30 (1995), 245–51, doi:10.1111/ j.1600-0765.1995.tb02129.x
26 R. L. Boyd, Longitudinal evaluation of a system for self-monitoring plaque control effectiveness in orthodontic patients, J Clin Periodontol, 10 1983/07/01 ed (1983), 380–8, doi:10.1111/j.1600-¬051x.1983.tb01287.x
27 P. Zhu, H. Lin, Y. Han, Y. Lin, Y. Xu, Z. Zhang, A computational fluid dynamic analysis of peri-bracket salivary flow influencing the microbial and periodontal parameters, PLoS One, 8 (2013), e62242, doi:10.1371/journal.pone.0062242
28 B. Rowshani, M. F. Timmerman, U. Van der Velden, Plaque development in relation to the periodontal condition and bacterial load of the saliva, J Clin Periodontol, 31 (2004), 214–8, doi:10.1111/j.0303-¬6979.2004.00468.x
29 P. Ramberg, P. Axelsson, J. Lindhe, Plaque formation at healthy and inflamed gingival sites in young individuals, J Clin Periodontol, 22 (1995), 85–8, doi:10.1111/j.1600-051x.1995.tb01775.x
30 I. S. Marques, A. M. Araujo, J. A. Gurgel, D. Normando, Debris, roughness and friction of stainless steel archwires following clinical use, Angle Orthod, 80 (2010), 521–7, doi:10.2319/081109-457.1
31 R. C. Araujo, L. M. Bichara, A. M. Araujo, D. Normando, Debris and friction of self-ligating and conventional orthodontic brackets after clinical use, Angle Orthod, 85 (2015), 673–7, doi:10.2319/012914-80.1
32 W. E. Moore, L. V. Holdeman, R. M. Smibert, D. E. Hash, J. A. Burmeister, R. R. Ranney, Bacteriology of severe periodontitis in young adult humans, Infect Immun, 38 (1982), 1137–48
33 Y. Yoshida, N. Suzuki, Y. Nakano, K. Shibuya, Y. Ogawa, T. Koga, Distribution of Actinobacillus actinomycetemcomitans serotypes and Porphyromonas gingivalis in Japanese adults, Oral Microbiol Immunol, 18 (2003), 135–9, doi:10.1034/j.1399-302x.2003.00034.x
34 M. P. Riggio, T. W. Macfarlane, D. Mackenzie, A. Lennon, A. J. Smith, D. Kinane, Comparison of polymerase chain reaction and culture methods for detection of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in subgingival plaque samples, J Periodontal Res, 31 (1996), 496–501, doi:10.1111/j.1600--0765.1996.tb01415.x
35 A. Sotošek, P. Videmšek, K. Seme, R. Gašperšič, Bakteriološka analiza subgingivalnih zobnih oblog slovenskih bolnikov s kroničnim parodontitisom, Zobozdrav vestn, 69 (2014), 12–20
36 J. Lindhe, N. P. Lang, T. Karring, Clinical Periodontology and Implant Dentistry, Oxford, Blackwell Munnksgard, 6th ed 2011
37 B. K. Wong, N. R. McGregor, H. L. Butt, R. Knight, L. Y. Liu, I. B. Darby, Association of clinical parameters with periodontal bacterial haemolytic activity, J Clin Periodontol, 43 (2016), 503–11, doi:10.1111/jcpe.12554
38 A. J. Ireland, V. Soro, S. V. Sprague, N. W. Harradine, C. Day, S. Al-Anezi, H. F. Jenkinson, M. Sherriff, D. Dymock, J. R. Sandy, The effects of different orthodontic appliances upon microbial communities, Orthod Craniofac Res, 17 (2014), 115–23, doi:10.1111/ ocr.12037
39 M. J. Thornberg, C. S. Riolo, B. Bayirli, M. L. Riolo, E. A. Van Tubergen, R. Kulbersh, Periodontal pathogen levels in adolescents before, during, and after fixed orthodontic appliance therapy, Am J Orthod Dentofacial Orthop, 135 (2009), 95–8, doi:10.1016/ j.ajodo.2007.02.057
40 G. Perinetti, M. Paolantonio, E. Serra, D. D’Archivio, S. D’Ercole, F. Festa, G. Spoto, Longitudinal monitoring of subgingival colonization by Actinobacillus actinomycetemcomitans, and crevicular alkaline phosphatase and aspartate aminotransferase activities around orthodontically treated teeth, J Clin Periodontol, 31 (2004), 60–7, doi:10.1111/j.0303-6979.2004.00450.x
41 J. F. Moulder, W. F. Stickle, P. E. Sobol, K. D. Bomben, Handbook of X-Ray Photoelectron Spectroscopy, Physical Electronics Inc., Eden Prairie, Minnesota, USA, (1995)
42 U. Mezeg, Evaluation of the surface characteristics of orthodontic brackets, archwires and their intraoral degradation processes, Doctoral thesis, Medical faculty, University, 2018, Ljubljana
Published
2021-03-16
How to Cite
1.
Ovsenik R, Pirc M, Primožič J, Schara R, Kovač J, Jenko M, Gašpirc B. EVALUATION OF MICROBIAL FLORA IN PATIENTS WITH GINGIVAL ENLARGEMENT DURING THE TREATMENT AND SURFACE CHEMISTRY OF FIXED ORTHODONTIC APPLIANCE ARCHWIRE. MatTech [Internet]. 2021Mar.16 [cited 2026Aug.9];55(1):51-7. Available from: https://mater-tehnol.si/index.php/MatTech/article/view/90
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