ABSTRACT
ABSTRACT Objective: To investigate the types of dental emergencies that occurred during the lockdown period in Italy (12th March-4th May) and to investigate future therapeutic preferences related to the use of different types of appliances. Material and Methods: A questionnaire dedicated to assessing dental emergencies during the lockdown period and surveying the resumption of orthodontic practice was submitted to clinicians in digital form. The first part of the questionnaire, focused on the orthodontic emergencies that were encountered in relation to the different types of orthodontic appliances and how these were resolved. The second part of the questionnaire was devoted to the resumption of clinical practice; in particular, it was designed to assess whether and what percentage of clinicians are willing to change the duration of appointments in relation to the different types of appliance used, asking them whether their approach to orthodontic treatment would change in the coming months as compared to the pre-COVID-19 era. Results: Results show that in most cases (82%), the percentage of patients who experienced a dental emergency was less than 5% and that far fewer emergencies were attributable to removable (5.7%) than to fixed appliances (94.3%). Looking ahead, clinicians expressed a greater preference for using removable (60.8%) rather than fixed appliances (39.2%). Conclusion: During the lockdown, there relatively few orthodontic emergencies, many of which were handled by telephone consultation. However, a far lower percentage of emergencies were generated by removable (e.g., clear aligners) as opposed to fixed appliances (e.g., multibracket equipment), likely influencing the decision of the majority of clinicians to opt for removable appliances in the wake of the COVID-19 pandemic.
Subject(s)
Orthodontic Appliances , Orthodontic Appliances, Removable/microbiology , Orthodontic Appliances, Fixed , COVID-19/virology , Italy/epidemiology , Surveys and Questionnaires , Emergencies/epidemiologyABSTRACT
O acometimento do indivíduo por patologias, como a cárie e doenças periodontais, pode ser traumático e extremamente devastador, podendo levá-lo a situações de grande comprometimento da saúde bucal e sistêmica. A introdução dos aparelhos removíveis pode predispor o desenvolvimento destas de modo que, além de aumentar o número populacional destes microrganismos, induz uma grande queda do pH intrabucal, favorecendo o processo de desmineralização dos tecidos duros e agredindo concomitantemente os tecidos moles. Logo, é necessário pesquisar e entender a fixação destes na superfície de aparelhos ortodônticos. A coleta foi realizada antes e 15 dias após a instalação dos aparelhos ortodônticos removíveis na cavidade bucal, mediante um esfregaço com swab estéril, aplicando movimentos anteroposteriores sob pressão manual na região do acrílico e na região dos parafusos expansores, quando houvesse. Na coleta inicial, houve crescimento de microrganismos em 15% dos casos para o Agar Mitis Salivarius, e 5% para o Ágar Sabouraud. Já na coleta após os 15 dias de instalação, verificou-se aumento para 100% de contaminação nas placas de Agar Mitis Salivarius, e as placas de Ágar Sabouraud permaneceram com os 5% de contaminação. Um padrão de limpeza mais bem elaborado desses aparelhos deve ser praticado pelos que o utilizam, além de estar indicada a substituição do aparato após algum tempo de uso, pois a inserção do aparelho modifica o ambiente da cavidade bucal.
The involvement of the individual by diseases such as caries and periodontal disease can be traumatic and extremely devastating and can lead one to situations of great commitment of oral and systemic health. Also, the introduction of removable appliances may predispose the development of these so that in addition to increasing the population of these microorganisms, it induces a large drop in the intraoral pH value, favoring the process of demineralization of hard tissues and simultaneously attacking the soft tissue, thus it is important to research and understand the fixation of these on the surface of orthodontic appliances. Data collection was conducted prior to installation of removable orthodontic appliances and 15 days after by a swipe with a sterile swab, applying movements from front to back under manual pressure in acrylic region and the region of expander bolts. At the first exam, 15% of cases had Agar Mitis Salivarius and 5% Agar Sabouraud. Fifteen days later, all appliances were contaminated with Agar Mitis Salivarius, while only 5% of devices were contaminated with Agar Sabouraud. A detailed cleaning must be exercised over these devices, along with replacement of the orthodontic device after some period because it can change the oral environment.
Subject(s)
Homeostasis , Oral Hygiene , Orthodontic Appliances, Removable/microbiology , In Vitro Techniques , Microbiological Techniques , Oral HealthABSTRACT
Adhesion and colonization of the oral cavity by Candida albicans is an initial step in candidosis. Orthodontic and other oral appliances seem to favor candidal presence. The aim of this work was to compare the presence of Candida species in saliva, their adherence to oral epithelial cells, and the levels of anti-C. albicans IgA in children with or without orthodontic appliances. This study included 30 children 5 to 12 years old (9.1 ± 1.7 years old) who were users of removable orthodontic devices for at least 6 months and 30 control children of similar ages (7.7 ± 1.5 years old). The presence of yeast species in the saliva was evaluated by microbiological methods. Candida species were identified using phenotypic methods. Anti-C. albicans IgA levels in saliva were analyzed by ELISA. The yeasts adhering to oral epithelial cells were assessed by exfoliative cytology. No statistically significant differences were observed for saliva yeast counts and anti-C. albicans IgA levels between the studied groups. Children with orthodontic devices exhibited more yeast cells adhering to oral epithelial cells and a higher percentage of non-albicans species relative to the control group. In conclusion, orthodontic appliances may favor the adherence of Candida to epithelial cells but do not influence the presence of these yeasts in saliva, and the levels of anti-C. albicans IgA do not correlate with yeast adherence or presence of Candida in the oral cavity.
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Candida/physiology , Epithelial Cells/microbiology , Immunoglobulin A/analysis , Orthodontic Appliances, Removable/microbiology , Saliva/microbiology , Analysis of Variance , Case-Control Studies , Cell Adhesion , Colony Count, Microbial , Candida/isolation & purification , Enzyme-Linked Immunosorbent Assay , Mouth Mucosa/microbiology , Reference ValuesABSTRACT
O objetivo deste estudo foi fazer uma revisão da literatura sobre a influência dos aparelhos ortodônticos fixos e removíveis no meio bucal, através da observação de alterações qualitativas e quantitativas dos microrganismos que normalmente fazem parte do ecossistema bucal. Os aparelhos removíveis acarretam uma diminuição no pH bucal, provocando um aumento no número de lactobacilos bem como no índice de placa. Quanto aos aparelhos fixos, aumentam o número de microrganismos na cavidade bucal, principalmente os lactobacilos e Streptococcus mutans, sendo que este aumento depende da duração do tratamento e do número de acessórios presentes.