In-office bacteria test for a microbial monitoring during the conventional and self-ligating orthodontic treatment
Open accessAbstract
This study investigated the microbial level of Streptococcus mutans and Lactobacillus spp. during an orthodontic treatment, and compare the data with untreated control subjects. Sixty young adult subjects were selected (average 20.5, DS 1.62), among which 40 underwent an orthodontic treatment (20 were treated with self-ligating brackets and 20 with conventional brackets) and 20 were controls. Plaque Index, salivary flow and buffering capacity of saliva were assessed before the beginning of the orthodontic treatment. Then the microbial counts were obtained by using an in-office bacteria test. The plaque index (PI) increased over time in each group as well as salivary flow, mostly in subjects treated with self-ligating brackets, suggesting a difference between conventional and self-ligating brackets. S.mutans showed a different trend of colonization in the two treated groups, as for subjects treated with conventional brackets it showed the greater value at the early stage of treatment (T1), followed by a decrease at T2. Lactobacillus spp. showed significant increase over time in the two treated groups, respect to the control group. Linear regression analysis showed no significant predictor for the microbial count at T2. The assortment of the various species of bacteria change over time during the orthodontic treatment, and seems to show different trends, depending on the type of orthodontic device. Consequently a periodical microbial monitoring using in-office bacteria tests, seems indicated.
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Three included trials concluded that conventional brackets encourage increased microbial colonisation compared with self-ligating brackets.
“Three trials concluded that CB encourage increased microbial colonisation compared to SLB (Ireland et al., 2014; Mummolo et al., 2013; Pellegrini et al., 2009)”
From Microbial colonisation associated with conventional and self-ligating brackets: a systematic review (2022) · cites this paper as Mummolo et al., 2013
The Results report significantly higher Lactobacillus colonization with conventional brackets than with self-ligating brackets at both measured follow-ups. But the Discussion says S. mutans was higher with conventional brackets at three months and lower later, so the unqualified claim of increased microbial colonization overstates this study's findings. The Discussion also specifies that colonization on bracket surfaces was not measured. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn Mummolo et al. 2013, there was a statistically significant increase in S. mutans salivary counts >105 for patients with conventional brackets compared with those with self-ligating brackets and control groups during the first three months of treatment.
“There was a statistically significant increase in S. mutans salivary counts >105 for patients with CBs compared to those with SLBs and control groups during the first three months of treatment (Mummolo et al., 2013).”
From Microbial colonisation associated with conventional and self-ligating brackets: a systematic review (2022) · cites this paper as Mummolo et al., 2013
The Discussion (page unavailable) reports that the conventional-bracket group had a marked increase in subjects with S. mutans counts >10⁵ at three months (60%). The Results (page unavailable) do not establish that this increase was statistically significant compared with both the self-ligating and control groups; they report a significant later decrease for S. mutans and significant between-treatment differences for Lactobacillus instead. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe external validity of Mummolo et al. 2013 is likely to be poor because it examined 18-23-year-olds, which is less representative of the average treatment age in the general population.
“The external validity of two studies is likely to be poor; Baka et al. (2013) investigated only male participants and Mummolo et al. (2013) examined 18–23-year-olds, which is less representative of the average treatment age in the general population.”
From Microbial colonisation associated with conventional and self-ligating brackets: a systematic review (2022) · cites this paper as Mummolo et al., 2013
Two papers had causes for concern for bias due to deviations from intended interventions because outcomes could have been affected by their intervention and analysis methods.
“Two papers had causes for concern (Baka et al., 2013; Mummolo et al., 2013) because outcomes could have been affected by their intervention and analysis methods.”
From Microbial colonisation associated with conventional and self-ligating brackets: a systematic review (2022) · cites this paper as Mummolo et al., 2013
The Material and methods sections describe the treatment groups and statistical analyses, but do not assess bias from deviations from intended interventions or say that the methods could have affected outcomes. I searched for those concerns and for details of assignment and analysis; the cited paper identifies the study being assessed, but its text does not establish the citing authors’ risk-of-bias judgment. (LLM, conf=0.72)
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References 16 · Cited by 51
Research works printed but not linked: 13
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- Authors
- Mummolo, S., Marchetti, E., Giuca, M. R., Gallusi, G., Tecco, S., Gatto, R., & Marzo, G.
- Affiliations
- University of L'Aquila (IT)
- University of Pisa (IT)
- Corresponding author
- Tecco, Simona
- ORCID
- Venue
- Head & Face Medicine
- Published
- 2013-02-01
- Volume
- 9
- Issue
- 1
- Pages
- 7-7
- ISSN
- 1746-160X (ISSN-L)
- PMC
- PMC3563582
- OpenAlex
- W2127435106
- Cited by
- 51
- References
- 16
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 2 · 2022: 3 · 2021: 6 · 2020: 6 · 2019: 8 · 2018: 6 · 2017: 1 · 2016: 2 · 2015: 1 · 2014: 6 · 2013: 1 · 2012: 1
- FWCI
- 4.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Head & Face Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion, cc-by-nc)
- Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
- Health Sciences › Dentistry › General Dentistry › Dental Research and COVID-19
- Keywords
- Streptococcus mutans, Lactobacillus, orthodontic treatment, self-ligating brackets, conventional brackets, dental plaque, salivary flow, saliva buffering capacity, oral microbiota, microbiological monitoring, caries risk
- MeSH terms
- Adolescent, Bacteriological Techniques, Dental Plaque Index, Female, Humans, Lactobacillus, Ligation, Male, Orthodontic Appliances, Salivation, Streptococcus mutans, Colony Count, Microbial, Orthodontic Appliance Design, Orthodontic Brackets, Young Adult
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