Use of Antimicrobial Silver Coatings on Fixed Orthodontic Appliances, Including Archwires, Brackets, and Microimplants: A Systematic Review.

Orthodontic treatments, while essential for achieving optimal oral health, present challenges in infection control due to the propensity for bacterial adhesion and biofilm formation on orthodontic appliances. Silver-coated orthodontic materials have emerged as a promising solution, leveraging the potent antimicrobial properties of silver nanoparticles (AgNPs). Antibacterial coatings are used in orthodontics to prevent the formation of bacterial biofilms. This systematic review evaluated the literature on antimicrobial silver coatings on fixed orthodontic appliances, including archwires, brackets, and microimplants. Two evaluators, working independently, rigorously conducted a comprehensive search of various databases, including PubMed, PubMed Central, Embase, Scopus and Web of Science. This systematic review comprehensively examined in vitro studies investigating the antimicrobial efficacy of silver-coated orthodontic archwires, brackets, and microimplants. The review registered in PROSPERO CRD42024509189 synthesized findings from 18 diverse studies, revealing consistent and significant reductions in bacterial adhesion, biofilm formation, and colony counts with the incorporation of AgNPs. Key studies demonstrated the effectiveness of silver-coated archwires and brackets against common oral bacteria, such as Streptococcus mutans and Staphylococcus aureus. Microimplants coated with AgNPs also exhibited notable antimicrobial activity against a range of microorganisms. The systematic review revealed potential mechanisms underlying these antimicrobial effects, highlighted implications for infection prevention in orthodontic practice, and suggested future research avenues. Despite some study heterogeneity and limitations, the collective evidence supports the potential of silver-coated orthodontic materials in mitigating bacterial complications, emphasizing their relevance in advancing infection control measures in orthodontics.

Effectiveness of methods for cleaning arch wire: an in vitro study

The aim of this study was to evaluate various methods of removing bacterial and fungus biofilm, to simulate orthodontic arch wires cleaning before reinsertion in the patients appliance. Rectangular Nickel Titanium (NiTi), Stainless Steel (SS) and Titanium Molybdenum (TMA) wires were divided into five groups, then contaminated with strains of Streptococcus mutans and Candida albicas. Four segments of each group served as control and were not contaminated. Six cleanings methods were used to remove the biofilm: cotton roll and a chemical agent (chlorhexidine, sodium hypochlorite, 70% alcohol), cotton roll and water, steel woll and immersion on enzymatic detergent. There was a control group not decontaminated Then wires were placed in broth separately, and after an incubation period the optical density (OD) was measured, observing whether there was microbial growth. A wire segment of each subgroup of SS 3M® was taken to the Scanning Electron Microscope (SEM) for visualization of the treatment response. The results were submitted to one-way ANOVA test and Tukey post-test. With the exception of 70% alcohol, the disinfection means behaved similarly regardless the type of wire. Two percent Chlorhexidine and 1% Sodium Hypochlorite totally removed the microorganisms while other agents left a high microbial concentration. Chemical cleaning is necessary to remove biofilm in orthodontic wires; 1% Sodium Hypochlorite and 2% Chlorhexidine are good disinfectants for this purpose.

Effects of TiO2-Coated Stainless Steel Orthodontic Wires on Streptococcus mutans Bacteria: A Clinical Study.

INTRODUCTION: The aim of this study was to clinically evaluate Streptococcus mutans adhesion on titanium dioxide-coated stainless steel orthodontic wires to decrease white-spot formation. METHODS: In this study, four groups of 17 patients each (n=68) aged 12-25 years participated. A titanium dioxide coating layer was deposited on 0.4572 mm stainless steel orthodontic wires using physical vapor deposition. The coated wires were randomly assigned to one jaw, and the opposite jaw received an uncoated wire as control. Patients were divided into groups according to the duration that wires were in their mouths: A) 1 week, B) 2 weeks, C) 3 weeks, and D) 4 weeks. Block randomization was used to assign patients to each group. At the end of the experiment, 20 mm of each wire (canine-to-canine area) was cut and cultured in S. mutans-specific medium. The culture plates were placed in an incubator containing 5% CO2 for 72 hours at 37°C, and then colonies were counted. MTT was used to test the biocompatibility of the coated and uncoated wires. To evaluate the stability of the coated titanium dioxide layer on the wires, titanium concentration on the saliva was determined using inductively coupled plasma mass spectroscopy. RESULTS: The Kruskal-Wallis test showed that there was no significant difference in colony counts among the coated wires during 1-4 weeks (p<0.48). In the uncoated-wire groups, colonys count at week 1 were higher than weeks 24 -(p<0.022). Wilcoxon's test showed that the number of colonies was significantly different in groups A and C, but there was no significant difference in groups B or D. MTT-assay results showed that there was not a significant difference between cell viability in the coated-wire group and the control. The Kruskal-Wallis test showed that there was no significant difference in titanium concentration in the studied groups (p<0.834). CONCLUSION: Application of titanium dioxide coating is effective in reducing bacterial adhesion at wire insertion.

Quantitative analysis of biofilm formation on labial and lingual bracket surfaces.

OBJECTIVES: To evaluate and compare the biofilm formation between labial and lingual orthodontic brackets. MATERIALS AND METHODS: Twenty patients with a mean age of 24 ± 8.8 who had received labial or lingual orthodontic treatment were enrolled in the study. Biofilm formation on 80 brackets was analyzed quantitatively with the Rutherford backscattering detection method. Five micrographs were obtained per bracket with views from the vestibule/lingual, mesial, distal, gingival, and occlusal aspects. Quantitative analysis was carried out with surface analysis software (ImageJ 1.48). Data were analyzed by Mann-Whitney U and Kruskal-Wallis tests (α = 0.05). RESULTS: Total biofilm formation was 41.56% (min 29.43% to max 48.76%) on lingual brackets and 26.52% (min 21.61% to max 32.71%) on labial brackets. Differences between the two groups were found to be significant. No difference was observed in intraoral location. The biofilm accumulation was mostly located on gingival, mesial, and distal surfaces for both groups. CONCLUSIONS: The biofilm accumulation on lingual orthodontic therapy was found to be more than labial orthodontic therapy.

Quantification of Streptococcus mutans in Different Types of Ligature Wires and Elastomeric Chains.

This study aimed to test the hypothesis that Streptococcus mutans contamination levels differ according to the type of the orthodontic ligature. Thirteen patients were selected. Each quadrant was randomly subjected to one of the following ligature-use protocols: I) elastomeric chain, II) steel ligature crossed over the archwire, III) steel ligature crossed under the archwire, and IV) steel ligature in a figure-eight pattern under the archwire. After seven days, the devices were removed and the Streptococcus mutans colony-forming unit count per mg of biofilm weight was determined. Twelve specimens (n=3) were also processed for scanning electron microscopy analysis. ANOVA and Tukey-Kramer test were used for comparisons to assess S. mutans differences between groups at a 5% significance level. There was no statistical difference in detectable levels of S. mutans among the groups (p=0.294). Scanning electron microscopy results showed abundant biofilms and microbial contamination in all groups. In conclusion, S. mutans contamination levels are similar in the different orthodontic ligatures.

Quantification of Streptococcus mutans in Different Types of Ligature Wires and Elastomeric Chains

Abstract This study aimed to test the hypothesis that Streptococcus mutans contamination levels differ according to the type of the orthodontic ligature. Thirteen patients were selected. Each quadrant was randomly subjected to one of the following ligature-use protocols: I) elastomeric chain, II) steel ligature crossed over the archwire, III) steel ligature crossed under the archwire, and IV) steel ligature in a figure-eight pattern under the archwire. After seven days, the devices were removed and the Streptococcus mutans colony-forming unit count per mg of biofilm weight was determined. Twelve specimens (n=3) were also processed for scanning electron microscopy analysis. ANOVA and Tukey-Kramer test were used for comparisons to assess S. mutans differences between groups at a 5% significance level. There was no statistical difference in detectable levels of S. mutans among the groups (p=0.294). Scanning electron microscopy results showed abundant biofilms and microbial contamination in all groups. In conclusion, S. mutans contamination levels are similar in the different orthodontic ligatures.

Resumo Este estudo teve como objetivo testar a hipótese de que os níveis de contaminação de Streptococcus mutans diferem de acordo com o tipo de ligadura ortodôntica. Treze pacientes foram selecionados. Cada quadrante foi submetido aleatoriamente a um dos seguintes protocolos de uso de ligadura: I) ligadura elastomérica, II) ligadura de aço trançada sobre o arco, III) ligadura de aço trançada sob o arco e IV) ligadura de aço em um padrão de "oito" sob o arco. Após sete dias, os dispositivos foram removidos e a contagem das unidades formadoras de colônia de S. mutans por mg de peso de biofilme foi determinada. Doze espécimes (n = 3) também foram processados para análise por microscopia eletrônica de varredura. Análise de variância e teste de Tukey-Kramer foram utilizados para comparações a fim de avaliar as diferenças de níveis de S. mutans entre os grupos com significância de 5%. Não houve diferença estatisticamente significante em níveis detectáveis de S. mutans entre os grupos (p = 0,294). Os resultados da microscopia eletrônica de varredura mostraram biofilmes abundantes e contaminação microbiana em todos os grupos. Em conclusão, os níveis de contaminação de S. mutans são semelhantes nas diferentes ligaduras ortodônticas.

Antimicrobial effect, frictional resistance, and surface roughness of stainless steel orthodontic brackets coated with nanofilms of silver and titanium oxide: a preliminary study.

Nano-silver and nano-titanium oxide films can be coated over brackets in order to reduce bacterial aggregation and friction. However, their antimicrobial efficacy, surface roughness, and frictional resistance are not assessed before. Fifty-five stainless-steel brackets were divided into 5 groups of 11 brackets each: uncoated brackets, brackets coated with 60 µm silver, 100 µm silver, 60 µm titanium, and 100 µm titanium. Coating was performed using physical vapor deposition method. For friction test, three brackets from each group were randomly selected and tested. For scanning electron microscopy and atomic-force microscopy assessments, one and one brackets were selected from each group. For antibacterial assessment, six brackets were selected from each group. Of them, three were immediately subjected to direct contact with S. mutans. Colonies were counted 3, 6, 24, and 48 h of contact. The other three were stored in water for 3 months. Then were subjected to a similar direct contact test. Results pertaining to both subgroups were combined. Groups were compared statistically. Mean (SD) friction values of the groups 'control, silver-60, silver-100, titanium-60, and titanium-100' were 0.55 ± 0.14, 0.77 ± 0.08, 0.82 ± 0.11, 1.52 ± 0.24, and 1.57 ± 0.41 N, respectively (p = .0004, Kruskal-Wallis). Titanium frictions were significantly greater than control (p < .05), but silver groups were not (p > .05, Dunn). In the uncoated group, colony count increased exponentially within 48 h. The coated groups showed significant reductions in colony count (p < .05, two-way-repeated-measures ANOVA). In conclusions, all four explained coatings reduce surface roughness and bacterial growth. Nano-titanium films are not suitable for friction reduction. Nano-silver results were not conclusive and need future larger studies.

Antiadherent and antibacterial properties of stainless steel and NiTi orthodontic wires coated with silver against Lactobacillus acidophilus--an in vitro study.

BACKGROUND: The purpose of the study is to assess the antiadherent and antibacterial properties of surface-modified stainless steel and NiTi orthodontic wires with silver against Lactobacillus acidophilus. METHODS: This study was done on 80 specimens of stainless steel and NiTi orthodontic wires. The specimens were divided into eight test groups. Each group consisted of 10 specimens. Groups containing uncoated wires acted as a control group for their respective experimental group containing coated wires. Surface modification of wires was carried out by the thermal vacuum evaporation method with silver. Wires were then subjected to microbiological tests for assessment of the antiadherent and antibacterial properties of silver coating against L. acidophilus. Mann-Whitney U test was used to analyze the colony-forming units (CFUs) in control and test groups; and Student's t test (two-tailed, dependent) was used to find the significance of study parameters on a continuous scale within each group. RESULTS: Orthodontic wires coated with silver showed an antiadherent effect against L. acidophilus compared with uncoated wires. Uncoated stainless steel and NiTi wires respectively showed 35.4 and 20.5 % increase in weight which was statistically significant (P < 0.001), whereas surface-modified wires showed only 4.08 and 4.4 % increase in weight (statistically insignificant P > 0.001). The groups containing surface-modified wires showed statistically significant decrease in the survival rate of L. acidophilus expressed as CFU and as log of colony count when compared to groups containing uncoated wires. It was 836.60 ± 48.97 CFU in the case of uncoated stainless steel whereas it was 220.90 ± 30.73 CFU for silver-modified stainless steel, 748.90 ± 35.64 CFU for uncoated NiTi, and 203.20 ± 41.94 CFU for surface-modified NiTi. CONCLUSIONS: Surface modification of orthodontic wires with silver can be used to prevent the accumulation of dental plaque and the development of dental caries during orthodontic treatment.

Synergy of brushing mode and antibacterial use on in vivo biofilm formation.

OBJECTIVES: Orthodontic, multi-strand retention-wires are used as a generalized model for oral retention sites to investigate whether biofilm left-behind after powered toothbrushing in-vivo enabled better penetration of antibacterials as compared with manual brushing. METHODS: 2-cm multi-strand, stainless-steel retention-wires were placed in brackets bonded bilaterally in the upper arches of 10-volunteers. Volunteers used NaF-sodium-lauryl-sulphate-containing toothpaste and antibacterial, triclosan-containing toothpaste supplemented or not with an essential-oils containing mouthrinse. Opposite sides of the dentition including the retention-wires, were brushed manually or with a powered toothbrush. Health-care-regimens were maintained for 1-week, after which wires were removed and oral biofilm was collected. RESULTS: When powered toothbrushing was applied, slightly less bacteria were collected than after manual brushing, regardless whether an antibacterial-regimen was used or not. Powered-toothbrushing combined with antibacterial-regimens yielded lower biofilm viability than manual brushing, indicating better antibacterial penetration into biofilm left-behind after powered brushing. Major shifts in biofilm composition, with a decrease in prevalence of both cariogenic species and periodontopathogens, were induced after powered brushing using an antibacterial-regimen. CONCLUSION: Oral biofilm left-behind after powered brushing in-vivo enabled better penetration of antibacterials than after manual brushing. CLINICAL SIGNIFICANCE: Mechanical removal of oral biofilm is important for prevention of dental pathologies, but biofilm is always left-behind, such as in fissures, buccal pits, interproximal areas and gingival margins and around orthodontic appliances. Use of antibacterial toothpastes or mouthrinses can contribute to removal or killing of biofilm bacteria, but biofilm structure hampers antibacterial penetration. A synergy between brushing mode and antibacterial-regimen applied exists with clinically demonstrable effects.

Effect of time and pH on physical-chemical properties of orthodontic brackets and wires.

OBJECTIVE: To test the hypothesis that treatment time, debris/biofilm, and oral pH have an influence on the physical-chemical properties of orthodontic brackets and arch wires. MATERIALS AND METHODS: One hundred twenty metal brackets were evaluated. They were divided into four groups (n  =  30) according to treatment time: group C (control) and groups T12, T24, and T36 (brackets recovered after 12, 24, and 36 months of treatment, respectively). Rectangular stainless-steel arch wires that remained in the oral cavity for 12 to 24 months were also analyzed. Dimensional stability, surface morphology, composition of brackets, resistance to sliding of the bracket-wire set, surface roughness of wires, and oral pH were analyzed. One-way analysis of variance, followed by a Tukey multiple comparisons test, was used for statistical analysis (P < .05). RESULTS: Carbon and oxygen were shown to be elements that increased expressively and in direct proportion to time, and there was a progressive increase in the coefficient of friction and roughness of wires as a function of time of clinical use after 36 months. Oral pH showed a significant difference between group T36 and its control (P  =  .014). CONCLUSIONS: The hypothesis was partially accepted: treatment time and biofilm and debris accumulation in bracket slots were shown to have more influence on the degradation process and frictional force of these devices than did oral pH.

Soybean extracts facilitate bacterial agglutination and prevent biofilm formation on orthodontic wire.

Soybean is an essential food ingredient that contains a class of organic compounds known as isoflavones. It is also well known that several plant agglutinins interfere with bacterial adherence to smooth surfaces. However, little is known about the effects of soybean extracts or genistein (a purified isoflavone from soybean) on bacterial biofilm formation. We evaluated the effects of soybean (Glycine max) extracts, including fermented soybean and genistein, on streptococcal agglutination and attachment onto stainless steel orthodontic wire. After cultivating streptococci in biofilm medium containing soybean extracts and orthodontic wire, the viable bacteria attached to the wire were counted. Phase-contrast microscopy and scanning electron microscopy (SEM) analyses were conducted to evaluate bacterial agglutination and attachment. Our study showed that soybean extracts induce agglutination between streptococci, which results in bacterial precipitation. Conversely, viable bacterial counting and SEM image analysis of Streptococcus mutans attached to the orthodontic wire show that bacterial attachment decreases significantly when soybean extracts were added. However, there was no significant change in pre-attached S. mutans biofilm in response to soybean. A possible explanation for these results is that increased agglutination of planktonic streptococci by soybean extracts results in inhibition of bacterial attachment onto the orthodontic wire.

Comparative short-term in vitro analysis of mutans streptococci adhesion on esthetic, nickel-titanium, and stainless-steel arch wires.

OBJECTIVE: To test the hypothesis that there are no differences in mutans streptococci (MS) adhesion between esthetic and metallic orthodontic arch wires based on their surface characteristics. MATERIALS AND METHODS: Surface roughness (Ra) and apparent surface free energy (SFE) were measured for six wires-four esthetic, one nickel-titanium (NiTi), and one stainless-steel (SS)-using profilometry and dynamic contact angle analysis, respectively. The amount of MS (Streptococcus mutans and Streptococcus sobrinus) adhering to the wires was quantified using the colony-counting method. The surfaces, coating layers, and MS adhesion were also observed by scanning electron microscopy. Statistical significance was set at P < .05. RESULTS: The Ra values of the esthetic wires were significantly different from one another depending on the coating method (P < .05). The NiTi wire showed the highest SFE, followed by the SS wire and then the four esthetic wires. The NiTi wires produced a significantly higher MS adhesion than did the SS wires (P < .05). The esthetic wires showed significantly lower MS adhesions than did the NiTi wire (P < .05). Pearson correlation analyses found moderate significant positive correlations between the SFE and the S mutans and S sobrinus adhesions (r  =  .636/.427, P < .001/P  =  .001, respectively). CONCLUSIONS: The hypothesis is rejected. This study indicates that some esthetic coatings on NiTi alloy might reduce MS adhesion in vitro in the short term.

Eficacia del JAL 90458 sobre el recrecimiento de placa en pacientes con aparatología fija multibrackets / Efficacy of JAL 90458 in the regrowth of plaque in patients with orthodontic braces

Introducción. El objetivo fue evaluar la eficacia del JAL 90458 sobre el recrecimiento de placa en pacientes con aparatología fija "multibrackets". Material y métodos. Participaron 16 sujetos (11 mujeres y 5 hombres) entre 12 a 39 años de edad. El estudio fue realizado bajo condiciones de un ensayo clínico, aleatorizado, doble ciego y paralelo de grupos balanceados usando un diseño de recrecimiento de placa. Los sujetos recibieron una profilaxis oral y suspendieron toda medida de higiene oral por los siguientes 4 días, usando sólo el gel asignado. Se evaluó el Índice de placa de Quigley-Hein modificado por Turesky (IPQH-T), el Índice de placa bracket (IPb) y el Índice de Sangrado al Sondaje (ISS). Para el análisis de datos se utilizó el test de la t de Student para muestras independientes, el test exacto de Fisher y el coeficiente de correlación de Pearson. Resultados. Se obtuvieron diferencias estadísticamente significativa entre el JAL 90458 y el gel control en el IPQH-T (2,52±0,57 vs 1,78±0,79, p<0,05), así como en el IPb (2,04±0,73 vs 1,27±0,59, p<0,05), y ISS (1,24±0,20 vs 0,48±0,24, p<0,05). Hubo una alta correlación entre el IPb y el IPQH-T (r=0,94, p<0,01). La ecuación de regresión lineal para predecir el valor del IPQH-T a través del IPb fue: IPQH-T=0,568+0,956 * IPb. Discusión. La aplicación del JAL 90458 en pacientes con aparatos fijos "multibrackets" demostró ser eficaz en la disminución del recrecimiento de placa bacteriana. No se detectó ningún efecto secundario clínico relevante (AU)

Introduction. The objective was test the efficacy of JAL 90458 on the regrowth of plaque in patients with orthodontic braces. Material and methods. A total of 16 subjects (11 women and 5 men) between the ages of 12 and 39 took part in this study. The study was conducted under clinical trial conditions, double blind, parallel and randomized in balanced groups using a plaque regrowth design. The subjects had a professional teeth-cleaning and were instructed to not use any kind of oral hygiene measures for the next four days, using only the gel that had been assigned to them. We took into account the following parameters: the Quigley - Hein plaque index, modified by Turesky (QHPI-T), Plaque-Bracket Index (PIb) and the Bleeding on Probing Index (BOP). Analysis of the data was done using a Student´s t-test, Fisher´s exact test and Pearson´s correlation coefficient. Results. Statistically significant differences between the JAL 90458 group and the control gel group were obtained in the QHPI-T (2.52±0.57 vs 1.78±0.79, p<0.05), as well as in the PIb (2.04±0.73 vs 1.27±0.59, p<0.05), and BOP (1.24±0.20 vs 0.48±0.24, p<0.05). There was a high correlation between the PIb and the QHPI-T (r=0.87, p<0.01). The linear regression equation to predict the value of the QHPI-T using the PIb was: QHPI-T=0.568+0.956 * PIb. Discussion. The application of JAL 90458 in patients with orthodontic braces was shown to be effective in the diminishing the regrowth of bacterial plaque. We did not detect any clinically relevant side effect (AU)

Biofilm associated microorganisms on removable oral orthodontic appliances in children in the mixed dentition.

OBJECTIVE: Biofilms on removable orthodontic appliances act as reservoir of microorganisms, capable of modifying the environmental condition of oral cavity and are difficult to be removed with routine hygiene measures. The present investigation includes enumeration, identification and numerical analysis of different types of cultivable bacteria associated with the biofilms on removable orthodontic appliances. STUDY DESIGN: Removable appliances of 25 healthy children among the ages of 10 to 14 years were taken to measure the prevalence of biofilms and type of microorganisms. For isolation of microorganism from biofilms different types of selective and non-selective medium based on standard methods were used. The data were further analysed by using Kolmogorov-Smirnov test, one-sample t-test and Spearman rank correlation coefficient. The percentage frequencies of isolates were also calculated RESULTS: The survey revealed the presence of both multi-species and mono species biofilms on appliances, with Non-Streptococci, anaerobic bacteria, Streptococcus spp., members of the family Enterobacteriaceae and Lactobacillus spp. as a dominant microbial flora of biofilms. Bacillus sp. and Candida sp. were isolated from one sample each. Significant positive and negative correlations were established among the species isolated from biofilms. CONCLUSION: Higher prevalence of the members of the family Enterobacteriaceae were reported during this study, advocating an extra hygienic measure is essential for this age group while wearing acrylic orthodontic appliances in oral cavity.

A computational fluid dynamic analysis of peri-bracket salivary flow influencing the microbial and periodontal parameters.

Fixed vestibular appliances decrease the "self-cleansing" action of saliva and promote aggregation of dental plaque by disturbing the salivary flow field on tooth surfaces, leading to a higher prevalence of enamel demineralization and periodontal diseases. In the current study, we investigated the salivary dynamic characteristics of plaque retention and periodontal status around appliances during orthodontic treatment. By reconstructing lower central incisors and orthodontic appliances, we simulated saliva flow on the tooth surface and then characterized and quantified the salivary flow pattern surrounding the bracket and archwire. In parallel, we tested the total peri-bracket bacterial counts and periodontal status to assess interrelations. Our results demonstrate that orthodontic appliances disturb the salivary flow field on tooth surfaces and can lead to a decrease in salivary velocity and an increase in bacterial numbers. Local vortexes forming in the areas gingival to the bracket, together with the narrow space limitation, contributed to the periodontal inflammatory response. This study confirms that changes in salivary flow are an obvious predisposing factor for bacterial accumulation, and advances the ability to replicate, in vitro, the salivary characteristics of plaque retention and periodontal status around appliances during orthodontic treatment.

Biofilm formation on stainless steel and gold wires for bonded retainers in vitro and in vivo and their susceptibility to oral antimicrobials.

OBJECTIVE: Bonded retainers are used in orthodontics to maintain treatment result. Retention wires are prone to biofilm formation and cause gingival recession, bleeding on probing and increased pocket depths near bonded retainers. In this study, we compare in vitro and in vivo biofilm formation on different wires used for bonded retainers and the susceptibility of in vitro biofilms to oral antimicrobials. MATERIALS AND METHODS: Orthodontic wires were exposed to saliva, and in vitro biofilm formation was evaluated using plate counting and live/dead staining, together with effects of exposure to toothpaste slurry alone or followed by antimicrobial mouthrinse application. Wires were also placed intra-orally for 72 h in human volunteers and undisturbed biofilm formation was compared by plate counting and live/dead staining, as well as by denaturing gradient gel electrophoresis for compositional differences in biofilms. RESULTS: Single-strand wires attracted only slightly less biofilm in vitro than multi-strand wires. Biofilms on stainless steel single-strand wires however, were much more susceptible to antimicrobials from toothpaste slurries and mouthrinses than on single-strand gold wires and biofilms on multi-strand wires. Also, in vivo significantly less biofilm was found on single-strand than on multi-strand wires. Microbial composition of biofilms was more dependent on the volunteer involved than on wire type. CONCLUSIONS: Biofilms on single-strand stainless steel wires attract less biofilm in vitro and are more susceptible to antimicrobials than on multi-strand wires. Also in vivo, single-strand wires attract less biofilm than multi-strand ones. CLINICAL SIGNIFICANCE: Use of single-strand wires is preferred over multi-strand wires, not because they attract less biofilm, but because biofilms on single-strand wires are not protected against antimicrobials as in crevices and niches as on multi-strand wires.

Monitoreo bacteriológico del instrumental utilizado en la práctica clínica de ortodoncia / Bacteriologic monitoring of the instruments used in orthodontic clinical practice

El objetivo del trabajo fue verificar la efectividad de procedimientos de esterilización en el instrumental de ortodoncia el objetivo del trabajo fue verificar la efectividad de procedimientos de esterilización en instrumental de ortodoncia. Seesterilizaron 10 juegos de instrumentos compuestos por alicates How recto, alicates Weingart, alicates de corte, retractores acrílicos, bastones de ligaduras elastoméricas y rollos decadenas elastoméricas. esterilización previa al trabajo: en autoclavelos alicates, en óxido de etileno los elementos plásticos y elastoméricos. Post esterilización in situ: alicates enesterilizador a bolitas de cuarzo; elementos elastoméricos y plásticos aerolizados en glutaraldehido al 2 por ciento. Se tomaron muestras con tubos de hisopos estériles, en dos momentos, 1: previo a la atención al paciente y 2: después de esterilización in situ. los tubos con turbidez macroscópica se colorearon con gram y cultivaron en medios de maC ConKey y Clde. Para cuantificar la carga microbiana, se realizaron tres siembras por estrías con ansa calibrada. momento 1: se encontrócontaminación con Corynebacterium en alicates Weingart y con Staphylococcus coagulasa negativo en los rollosde cadena.momento 2: contaminación con Corynebacterium en retractores; con Staphylococcus coagulasa negativo en alicates de corte, en retractores acrílicos, en bastones de ligadura;con Micrococcus en alicates How rectos. La presencia de cargas bacterianas no satisfactorias sugiere que los procedimientos habituales de esterilización no fueron eficaces.(AU)

Monitoreo bacteriológico del instrumental utilizado en la práctica clínica de ortodoncia / Bacteriologic monitoring of the instruments used in orthodontic clinical practice

El objetivo del trabajo fue verificar la efectividad de procedimientos de esterilización en el instrumental de ortodoncia el objetivo del trabajo fue verificar la efectividad de procedimientos de esterilización en instrumental de ortodoncia. Seesterilizaron 10 juegos de instrumentos compuestos por alicates How recto, alicates Weingart, alicates de corte, retractores acrílicos, bastones de ligaduras elastoméricas y rollos decadenas elastoméricas. esterilización previa al trabajo: en autoclavelos alicates, en óxido de etileno los elementos plásticos y elastoméricos. Post esterilización in situ: alicates enesterilizador a bolitas de cuarzo; elementos elastoméricos y plásticos aerolizados en glutaraldehido al 2 por ciento. Se tomaron muestras con tubos de hisopos estériles, en dos momentos, 1: previo a la atención al paciente y 2: después de esterilización in situ. los tubos con turbidez macroscópica se colorearon con gram y cultivaron en medios de maC ConKey y Clde. Para cuantificar la carga microbiana, se realizaron tres siembras por estrías con ansa calibrada. momento 1: se encontrócontaminación con Corynebacterium en alicates Weingart y con Staphylococcus coagulasa negativo en los rollosde cadena.momento 2: contaminación con Corynebacterium en retractores; con Staphylococcus coagulasa negativo en alicates de corte, en retractores acrílicos, en bastones de ligadura;con Micrococcus en alicates How rectos. La presencia de cargas bacterianas no satisfactorias sugiere que los procedimientos habituales de esterilización no fueron eficaces.

Biofilm retention by 3 methods of ligation on orthodontic brackets: a microbiologic and optical coherence tomography analysis.

INTRODUCTION: The aim of this study was to evaluate biofilm retention around orthodontic brackets related to the method of ligation by using optical coherence tomography (OCT) and microbiologic sampling. METHODS: Seventy-five plastic central incisors for dentures were divided into 3 groups and used with metal brackets with a 0.022-in slot with elastomeric ligature (n = 25), metal brackets with a 0.022-in slot with steel wire ligature (n = 25), and self-ligating brackets with a 0.022-in slot (n = 25). The samples were submersed in a suspension of Streptococcus mutans, genetically engineered to express green fluorescent protein, at 37°C for 72 hours to allow biofilm formation. The samples were then submitted to microbiologic analysis and OCT imaging. RESULTS: The microbiologic analysis and the OCT showed significant differences in biofilm formation depending on the ligating method. Brackets ligated with elastomeric rings held more S mutans biofilm, and steel wire ligation had less biofilm retention compared with the other brackets. CONCLUSIONS: This study provided validation that OCT can be used as a potential qualitative marker of total plaque bacteria that can be rapidly and reliably visualized around orthodontic brackets.