• International Journal of Clinical Preventive Dentistry
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• v.14 no.4
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• pp.209-215
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• 2018

In recent years, the numbers of the orthodontic dental patients have been rapidly increased in adolescent or young adult aged generation. It has been well known that it would be very hard to control the oral hygiene cares for orthodontic applied dental patient because of the complexity of the appliance. So the caries prevalence of the orthodontic dental patients would be higher than non-appliance persons, and it might be easy to cause the dental caries especially on the labial or buccal surface of the tooth through equipping the fixed type appliance with a long period, even though the alignment of the teeth would be arranged well. So, the massive preventive program for preventive dentistry should be needed for the dental patients for orthodontic treatment, in order to protect the dental caries and the periodontal disease for them. But, lots of the dentists or dental hygienists sometimes neglect of this point for preventive dental cares orthodontic dental patients, or do not know the importance and how to manage the skill for the preventive dental works in clinical. In this article, it will be introduced the basic theories and skills for preventive cares as tooth-brushing instruction, fluoride topical application and pit and fissure sealant, scaling and professional mechanical tooth cleansing and the diet control, for the dental patients with the fixed type of the orthodontic appliance, in case by case.

• The korean journal of orthodontics
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• v.30 no.3 s.80
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• pp.335-342
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• 2000

The authors observed the long term effects of chlorhexidine varnish treatment on microbial change of dental plaque in orthodontic patients with fixed appliances. The initial sample was 100 patients who were arranged to be treated with fixed orthodontic appliances. The final sample consisted of 21 patients who could be traced for 32 weeks after application of fixed orthodontic appliances. They were classified into the experimental group (12 patients) and the control group (9 patients). The experimental group was treated with chlorhexidine varnish once a week for 4 weeks before application of fixed orthodontic appliance. The control group was not treated with chlorhexidine varnish before application of fixed orthodontic appliance. The experimental group was treated once more after 20 weeks. The microbial changes of dental plaque were analysed by indirect immunofluorescence technique at pre-treatment, post-treatment 4, 8, 20, and 32 weeks. The results were as follows. 1. In the experimental group, streptococus mutans was significantly suppressed during experimental period. (p<0.01) But, in the control group, streptococcus mutans was significantly increased after placement of fixed orthodontic appliances during experiment period. (p<0.05) 2. Streptococcus sanguis, Streptococcus mitis, Actinomyces viscosus, md Actinomyces naeslundii did not show significant change between the experimental and the control group during experiment period. So, if we treat the orthodontic patients with chlorhexidine varnish before application of fixed appliances, we may suppress the major cariogenic bacteria, Streptococcus mutans, selectively for long period.

• Journal of Periodontal and Implant Science
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• v.51 no.3
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• pp.163-178
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• 2021

Purpose: The aim of this study was to evaluate clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients. Methods: In total, 52 patients with at least 2 years of follow-up after periodontal and orthodontic treatment were included in this study. After scaling and root planing, orthodontic treatment with fixed appliances or clear aligners was performed. Fixed retainers with twist-flex stainless steel wires were bonded to the palatal or lingual sides of anterior teeth. Changes in clinical parameters, including the plaque index, gingival index, calculus index (CI), probing pocket depth, and radiographic bone levels, were evaluated before bonding of fixed retainers and at a 12-month follow-up. Cumulative survival rates (CSRs) for retainer failure were evaluated according to sex, site, CI, stage of periodontitis, and the severity of the irregularity with the log-rank test and hazard ratios (HRs). Results: Twelve months after bonding of fixed retainers, improvements were observed in all clinical parameters except CI and radiographic bone gain. The overall CSR of the retainers with a CI <1 at the 12-month follow-up after bonding of fixed retainers was significantly higher than that of the retainers with a CI ≥1 at the 12-month follow-up (log-rank test; P<0.001). Patients with stage III (grade B or C) periodontitis had a higher multivariate HR for retainer failure (5.4; 95% confidence interval, 1.22-23.91; P=0.026) than patients with stage I (grade A or B) periodontitis. Conclusions: Although fixed retainers were bonded in periodontitis patients, periodontal health was well maintained if supportive periodontal treatment with repeated oral hygiene education was provided. Nonetheless, fixed retainer failure occurred more frequently in patients who had stage III (grade B or C) periodontitis or a CI ≥1 at 12-month follow-up after bonding of fixed retainers.

• The Journal of the Korean dental association
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• v.48 no.5
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• pp.371-378
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• 2010

The objective of this study was to compare the effectiveness of essential oil mouthrinse and interdental brush for oral hygiene in orthodontic patient. 90 patients, with fixed orthodontic appliances, were divided into 3 groups(Group 1: patients who had only used toothbrush, group 2: toothbrush + essential oil mouthrinse, group 3: toothbrush + interdental brush). Then, plaque index(PI) and gingival index(GI) were evaluated at before(T0), 3 weeks after(Tl) and 6 weeks after(T2) the experiment. The present study revealed the following conclusions: (1) There was statistically significant decrease in PI and GI of groups 2 and 3 comparing to those of group 1 during 6 weeks.(p<0.05) (2) There was no significant difference in the level of decrease in PI and GI between group 2 and group 3.(p<0.05) The present study thus implied that use of mechanical or chemical aid such as interdental brush and mouth rinse in addition to toothbrushing may help maintaining oral hygiene in patients undergoing fixed orthodontic treatment for prolonged duration.

• The korean journal of orthodontics
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• v.23 no.4 s.43
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• pp.661-669
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• 1993

The purpose of this study was to investigate a possibility of chronic or intermittent bacteremia in patients undergoing orthodontic treatment with fixed orthodontic appliance. Orthodontic patients who had been injured by orthodontic appliances and/or suffered from gingivitis were selected. They had not taken any antibiotics for 1 month. The number of subjects were 21 including 7 males and 14 females. Blood samples of the subjects were cultured and, IgG, IgA and IgM levels in the serum were quantified. The author found following results. 1. No bacterial growth was found in 7-day culture of all the samples. 2. The immunoglobulin levels in serum were confined in normal range. 3. This study could not deny the possibility of transient bacteremia episode undergoing orthodontic treatment.

• Journal of Oral Medicine and Pain
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• v.23 no.2
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• pp.109-117
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• 1998

Fixed orthodontic appliances for the treatment of malocclusion has iatrogenic side effect such as demineralization of enamel, gingivitix and gingival hyperplasia. The purpose of this study is to longitudinally investigate the salivary microorganisms and immunoglobulin A after delivery of fixed orthodontic appliances for 10 months. Eight orthodontic patients were included in this study and the author has investigated the numbers of general bacteria, Streptococcus mutans Staphylococcus aureus and concentration of immunoglobulin A from unstimulated whole saliva. The author examined these parameters at prebracketing, 1 month after, 4 months after, 7 months after and 10 months after delivery of fixed orthodontic appliances. The obtained results were as follows : There were significant increases in the number of salivary general bacteria, Streptococcus mutans and Staphylococcus aureus after delivery of fixed orthodontic appliances The numbers of general bacteria were significantly increased at 1 month after (p<005), 4 months after (p<0.05), 7 months after (p<0.01), compared with prebracketing. However it showed no difference at 10 month after compared with 7 months after bracketing. The Numbers of Staphylococcus aureus were significantly increased at 1 month after (p<0.05), 4 months after(p<0.01), 7 month(p<0.01), compared with prebracketing. However it showed decreasing pattern at 10 months after compared with 7 months after bracketing. There was no significant difference in the concentration of immunoglobulin A after delivery of fixed orthodontic appliances.

• Journal of Periodontal and Implant Science
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• v.45 no.6
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• pp.193-204
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• 2015

Purpose: With the increasing prevalence of orthodontic treatment in adults, clear aligner treatments are becoming more popular. The aim of this study was to evaluate the effect of orthodontic treatment on periodontal tissue and to compare orthodontic treatment with fixed appliances (FA) to clear aligner treatment (CAT) in periodontitis patients. Methods: A total of 35 patients who underwent orthodontic treatment in the Department of Periodontology were included in this study. After periodontal treatment with meticulous oral hygiene education, patients underwent treatment with FA or CAT, and this study analyzed patient outcomes depending on the treatment strategy. Clinical parameters were assessed at baseline and after orthodontic treatment, and the duration of treatment was compared between these two groups. Results: The overall plaque index, the gingival index, and probing depth improved after orthodontic treatment (P<0.01). The overall bone level also improved (P=0.045). However, the bone level changes in the FA and CAT groups were not significantly different. Significant differences were found between the FA and CAT groups in probing depth, change in probing depth, and duration of treatment (P<0.05). However, no significant differences were found between the FA and CAT groups regarding the plaque index, changes in the plaque index, the gingival index, changes in the gingival index, or changes in the alveolar bone level. The percentage of females in the CAT group (88%) was significantly greater than in the FA group (37%) (P<0.01). Conclusions: After orthodontic treatment, clinical parameters were improved in the FA and CAT groups with meticulous oral hygiene education and plaque control. Regarding plaque index and gingival index, no significant differences were found between these two groups. We suggest that combined periodontal and orthodontic treatment can improve patients' periodontal health irrespective of orthodontic techniques.

• Journal of Microbiology
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• v.43 no.3
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• pp.260-265
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• 2005

The objective of this study was to detect and compare the presence of periodontopathogens in the subgingival plaques of gingivitis lesions in adults who wore fixed orthodontic appliances, as opposed to adults who did not wear any orthodontic appliances. Thirty-six individuals participated in this study. Ninteen of these subjects did not wear any orthodontic appliances, and these subjects comprised the control group. The other 17 individuals had been wearing fixed orthodontic appliances for at least 3 months each. After a periodontal examination, we collected subgingival plaque samples from the gingivitis lesions of each patient. Using PCR based on 168 rDNA, we detected the presence of 6 putative periodontopathogenic species, Treponema denticola, Porphyromonas gingivalis, Tannerella forsythia (formerly Bacteroides forsythus), Prevotella nigrescens, Prevotella intermedia, and Actinobacillus actinomycetemcomitans. With regard to the presence of individual periodontopathogens, we found that T. forsythia, T. denticola, and P. nigrescens were significantly more common in the samples obtained from the orthodontic patients than in the samples obtained from the non-orthodontic patient controls. Our results indicate that the local changes associated with the wearing of fixed orthodontic appliances may affect the prevalence of periodontopathogens in subgingival dental plaques.

• Journal of Korean society of Dental Hygiene
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• v.17 no.5
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• pp.747-755
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• 2017

Objectives: The purpose of study is to investigate periodontal disease-related recognition and oral health-related behavior in orthodontic patients with fixed appliance. Methods: A self-reported questionnaire was completed by 286 orthodontic patients with fixed appliance in Gwangju, Jeonnam from September 1 to September 27, 2016. The questionnaire consisted of general characteristics (3 items), orthodontic related characteristics (3 items), knowledge of periodontal disease (3 items), and oral health-related behavior (4 items). The data were analyzed by frequency analysis, percentage and chi-square analysis using SPSS 21.0 program. Results: 62.8% had experiences of dental treatment and 67.5% had intention of involvement on incremental care program in orthodontic treatment periods. Accuracy rate of cause about periodontal disease was high in female and case of acquiring information experiences on periodontal disease (p<0.05). 67.2% performed correct toothbrushing for the management of periodontal disease in the experiences of acquiring information on periodontal disease in orthodontic treatment periods (p<0.05). The proportions of using interdental toothbrush and mouth rinsing solutions were high among those over 20 years old and students in the subjects (p<0.05). Conclusions:The accuracy rate were high in the answers about cause and management of periodontal disease in case of acquiring information experiences on periodontal disease in orthodontic treatment periods. Therefore, there is a need to further development and implementation of dental hygiene intervention program for periodontal disease care with fixed orthodontic appliances in that regard.

• The korean journal of orthodontics
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• v.53 no.6
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• pp.365-373
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• 2023

Objective: To investigate the potential correlation between fixed orthodontic retention failure and several patient- and treatment-related factors. Methods: Patients finishing treatment with fixed appliances between 2016 and 2017 were retrospectively included in this study. Those not showing fixed retention failure were considered as control group. Patients with fixed retention failure were considered as the experimental group. Additionally, patients with failure of fixed retainers in the period of June 2019 to March 2021 were prospectively identified and included in the experimental group. The location of the first retention failure, sex, pretreatment dental occlusion, facial characteristics, posttreatment dental occlusion, treatment approach and presence of oral habits were compared between groups before and after treatment separately by using a Fisher exact test and a Mann-Whitney U test. Results: 206 patients with fixed retention failure were included, 169 in the mandibular and 74 in the maxillary jaws. Significant correlations were observed between retention failure in the mandibular jaws and mandibular arch length discrepancy (P = 0.010), post-treatment growth pattern (P = 0.041), nail biting (P < 0.001) and abnormal tongue function (P = 0.002). Retention failure in the maxillary jaws was more frequent in patients with IPR in the mandibular jaws (P = 0.005) and abnormal tongue function (P = 0.021). Conclusions: This study suggests a correlation between fixed retention failure and parafunctional habits, such as nail biting and abnormal tongue function. Prospective studies with larger study populations could further confirm these results.