Alterations in plaque accumulation and gingival inflammation promoted by treatment with self-ligating and conventional orthodontic brackets

original article Alterations in plaque accumulation and gingival inflammation promoted by treatment with self-ligating and conventional orthodontic brackets Mauricio de Almeida Cardoso1, Patrícia Pinto Saraiva2, Liliana Ávila Maltagliati3, Fernando Kleinübing Rhoden4, Carla Cristina Alvarenga Costa5, David Normando6, Leopoldino Capelozza Filho1 DOI: http://dx.doi.org/10.1590/2176-9451.20.2.035-041.oar Objective: The aim of the present study was to evaluate, comparatively, the periodontal response during orthodontic treatment performed with self-ligating and conventional brackets.Methods: Sixteen Caucasian individuals of both sexes, aged between 12 and 16 years old and in permanent dentition were selected. Eight individuals were treated with conventional brackets installed on the lower dental arch and self-ligating brackets on the upper arch. Another eight individuals received self-ligating brackets in the lower arch and conventional brackets in the upper arch. The subjects received material and instructions for oral hygiene. Visible plaque index (VPI), gingival bleeding index (GBI) and clinical attachment level (CAL) were evaluated just after installation of orthodontic appliances, and 30, 60 and 180 days later. Mann-Whitney test was used to compare differences between groups (self-ligating and conventional), twoway ANOVA followed by Tukey’s test was used to assess CAL at each site of each tooth. Significance level was set at 5%. Results: No significant changes were found with regard to the assessed parameters (VPI, GBI and CAL) in either one of the systems.Conclusion: No significant changes were found with regard to the periodontal response to orthodontic treatment for the variables assessed and between subjects receiving passive self-ligating and conventional brackets. All individuals had received oral hygiene instructions and had their periodontal conditions monitored. Keywords: Corrective Orthodontics. Periodontium. Periodontal index. Dental visible plaque index. Objetivo: o objetivo do presente estudo foi avaliar, comparativamente, a resposta periodontal durante o tratamento ortodôntico realizado com braquetes autoligáveis e convencionais. Métodos: dezesseis indivíduos, leucodermas, em dentição permanente, de ambos os sexos, com idades de 12 a 16 anos, foram selecionados. Oito foram tratados com braquetes convencionais instalados na arcada inferior, e braquetes autoligáveis na arcada superior. Os outros oito indivíduos receberam braquetes autoligáveis na arcada inferior e braquetes convencionais na arcada superior. Os pacientes receberam materiais e instruções sobre higiene bucal. O índice de placa visível (IPV), o índice de sangramento gengival (ISG) e o nível de inserção clínica (NIC) foram avaliados logo após a instalação do aparelho e 30, 60 e 180 dias mais tarde. Para comparar as diferenças entre os grupos (braquetes autoligáveis e convencionais), foi utilizado o teste Mann-Whitney; para analisar o NIC em cada local de cada dente, foi utilizada a análise de variância de duas vias, seguida do teste de Tukey, com nível de significância a 5%. Resultados: não houve alteração significativa nos parâmetros avaliados (IPV, ISG e NIC), em nenhum dos dois sistemas. Conclusão: a resposta periodontal ao tratamento ortodôntico não apresentou diferenças significativas, para nenhuma das variáveis analisadas, entre os indivíduos tratados com braquetes autoligáveis passivos e braquetes convencionais, os quais receberam instruções quanto à adequada higienização bucal e foram submetidos ao monitoramento das condições periodontais. Palavras-chave: Ortodontia corretiva. Periodonto. Índice periodontal. Índice de placa bacteriana. Acknowledgements: to the companies Abzil-3M and Oral-B, for the sponsorship granted to the present study; also for the funding (FAP / USC) granted by Universidade Sagrado Coração’s financing agency (USC / Bauru). » Patients displayed in this article previously approved the use of their facial and intraoral photographs. How to cite this article: Cardoso MA, Saraiva PP, Maltagliati LA, Rhoden FK, Costa CCA, Normando D, Capelozza Filho L. Alterations in plaque accumulation and gingival inflammation promoted by treatment with self-ligating and conventional orthodontic brackets. Dental Press J Orthod. 2015 Mar-Apr;20(2):35-41. DOI: http://dx.doi.org/10.1590/2176-9451.20.2.035-041.oar Professor of Orthodontics, Universidade Sagrado Coração (USC), Department of Oral Biology, Bauru, São Paulo, Brazil. 2 Professor of Periodontology, Universidade Sagrado Coração (USC), Department of Oral Biology, Bauru, São Paulo, Brazil. 3 MSc and PhD in Orthodontics, Universidade de São Paulo, School of Dentistry (FOB-USP), Bauru, São Paulo, Brazil. 4 PhD resident in Oral Biology, Universidade Sagrado Coração (USC), Department of Oral Biology, Bauru, São Paulo, Brazil. 5 DDS, Universidade Sagrado Coração (USC), Bauru, São Paulo, Brazil. 6 Adjunct professor, Universidade Federal do Pará (UFPA), Belém, Pará, Brazil. 1 © 2015 Dental Press Journal of Orthodontics Submitted: September 08, 2013 - Revised and accepted: March 10, 2014 » The authors report no commercial, proprietary or financial interest in the products or companies described in this article. Contact address: Mauricio de Almeida Cardoso University of Sagrado Coração. Rua Irmã Arminda, 10-50, Jardim Brasil, Bauru – SP, CEP 17.011-160, Brazil. E-mail: 35 Dental Press J Orthod. 2015 Mar-Apr;20(2):35-41 original article Alterations in plaque accumulation and gingival inflammation promoted by treatment with self-ligating and conventional orthodontic brackets Self-ligating brackets have been a major focus of attention in Orthodontics in recent years, which explains the various designs developed by manufacturers of orthodontic material. All of them have very similar characteristics and can be divided into two groups: active and passive brackets.10 In a study conducted by Pellegrini et al,5 with the objective of assessing accumulation of bacterial plaque in self-ligating and conventional brackets, the authors concluded that active self-ligating brackets are less likely to accumulate dental plaque when compared to conventional brackets. Nevertheless, it is speculated that active self-ligating brackets allow better hygiene, as they do not have locks or clips completely closing the bracket slot and forming a fourth wall (buccal) similar to molar tubes. Passive brackets, on the other hand, present a buccal wall and, for this reason, could cause plaque accumulation inside the bracket slot. There is no report of significant difference in the number of bacteria found in self-ligating brackets, compared to conventional ones tied with elastomeric ligatures, whether in metal14,16 or aesthetic brackets.15 Depending on the type of brackets used, different microbial trends were found in a study conducted by Mummolo et al.17 The authors collected saliva samples from 60 patients, divided into three groups of 20 patients each (s (...truncated)