IADR Abstract Archives
Microbiome Changes in Orthodontic Patients with Brackets Versus Clear Aligners
Objectives: Traditional fixed appliances (FA) and clear aligners (CA) are both used to achieve corrective orthodontic movement in patients. However, few studies have compared how these therapies affect the oral microbiome. The aim of this study is to perform a comprehensive longitudinal evaluation of the oral microbiome in patients treated with FA versus CA and evaluate its clinical implications.
Methods: A pilot group of 4 FA and 4 CA patients was selected for preliminary analysis. Oral biofilm was collected prior to treatment (T0) and at 1-month (T1), 3-month (T3), and 6-month (T6) intervals from central incisors, first premolars, and the most recently worn clear aligners. DNA was extracted and sequenced via next generation 16s rRNA gene sequencing. Oral health was recorded using the Plaque Index (PI) and Gingival Index (GI).
Results: PI increased significantly over time between T0 and T6 in both groups (FA p<0.01; CA p=0.054); a larger increase was noted in the FA group (FA mean increase=2.2; CA mean increase=0.845). GI scores increased significantly in the FA group (p<0.01) but no significant increase was noted in the CA group. Beta-diversity analysis showed plaque samples collected from CA trays clustered separately from oral biofilm samples. Taxa composition analysis reveals a shift in the oral microbiome after beginning treatment and a unique microbial community in the clear aligner trays. Alpha diversity increased in all three types of biofilm over the 6-month collection time period, but tray biofilm was notably less diverse overall.
Conclusions: Both FA and CA orthodontic treatment significantly increase plaque accumulation, although a greater increase is noted in patients with FA. FA resulted in significantly increased gingival inflammation, while CA showed no significant increase. Tray biofilm is significantly different from oral biofilm. Further analyses on additional patients currently enrolled is needed to confirm these preliminary findings.
Methods: A pilot group of 4 FA and 4 CA patients was selected for preliminary analysis. Oral biofilm was collected prior to treatment (T0) and at 1-month (T1), 3-month (T3), and 6-month (T6) intervals from central incisors, first premolars, and the most recently worn clear aligners. DNA was extracted and sequenced via next generation 16s rRNA gene sequencing. Oral health was recorded using the Plaque Index (PI) and Gingival Index (GI).
Results: PI increased significantly over time between T0 and T6 in both groups (FA p<0.01; CA p=0.054); a larger increase was noted in the FA group (FA mean increase=2.2; CA mean increase=0.845). GI scores increased significantly in the FA group (p<0.01) but no significant increase was noted in the CA group. Beta-diversity analysis showed plaque samples collected from CA trays clustered separately from oral biofilm samples. Taxa composition analysis reveals a shift in the oral microbiome after beginning treatment and a unique microbial community in the clear aligner trays. Alpha diversity increased in all three types of biofilm over the 6-month collection time period, but tray biofilm was notably less diverse overall.
Conclusions: Both FA and CA orthodontic treatment significantly increase plaque accumulation, although a greater increase is noted in patients with FA. FA resulted in significantly increased gingival inflammation, while CA showed no significant increase. Tray biofilm is significantly different from oral biofilm. Further analyses on additional patients currently enrolled is needed to confirm these preliminary findings.