hrvatski

Supragingival biofilm composition changes during orthodontic treatment and chlorhexidine use.

Aim: This study explored effect of chlorhexidine digluconate (CHX) on bacterial composition of supragingival biofilm related to gingivitis in patients in orthodontic treatment. Subjects and methods: Sample consisted of 30 subjects in orthodontic treatment with fixed orthodontic appliance aged 10-41 years (median 14, interquartile range 13-15, 58% females), randomly assigned to two groups. There were 16 subjects in control group practicing regular oral hygiene, and 14 subjects in group that used CHX mouthwash (0.12%) twice per day for 30 days. Samples of supragingival biofilm were collected before and during orthodontic treatment. Real time polymerase chain reaction was used for analysis of changes in bacterial biofilm composition for Veillonella parvula, Aggregatibacter actinomycetemcomitans, Streptococcus salivarius, sobrinus and mutans species. Changes between groups were compared by Mann-Whitney test and Spearman correlation. Results: Fixed orthodontic appliance when practicing regular oral hygiene increased tested bacterial species, mostly S. mutans (37.4x) and S. salivarius (5.6x), moderately V. parvula (3.5x) while least A. actinomycetemcomitans and S. sobrinus (2x each). Increase of V. parvula linearly increased S. salivarius (r=0.726 ; p=0.001). The use of CHX in comparison to patients without CHX mostly reduced S. sobrinus (5x) and A. actinomycetemcomitans (2.5x) while S. salivarius (1.4x) and V. parvula (1.2x) showed small reduction. S. mutans increases (8x) but to a lesser extent than without CHX treatment. The change in A. actinomycetemcomitans and S. sobrinus due to CHX treatment was linearly positively related (r=0.587 ; p=0.027), as well as V. parvula and S. mutans (r=0.600 ; p=0.023). Large interindividual variability in clinical intraoral changes in biofilm accumulation intensity and gingivitis extent was present and differences between groups did not reach statistical significance. Conclusion: Use of CHX during orthodontic tretament changed bacterial composition of supragingival biofilm by reducing periodontal patogenes but also cariogenic bacteria.

dental biofilm ; bacteria ; orthodontics ; chlorhexidine

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