Evaluation of the Contamination of Ligatures
Condition: Orthodontics
Study type: Interventional

Summary: 
      This crossover, in-vivo study was carried out with 10 patients who have been started to be
      treated at Orthodontics Department. 3 elastomeric ligatures were examined in terms of
      microbiological and surface roughness.
    

Detailed description: 
      The development of dental plaque has been associated with several environmental and
      individual factors including diet composition, oral hygiene, the quality of saliva, the
      composition of the oral microflora and immune factors. Orthodontic fixed appliances also
      impede the maintenance of oral hygiene. Plaque accumulation surrounding orthodontic
      appliances leads to enamel demineralization caused by organic acids produced by bacteria in
      the dental plaque.

      In patients with fixed orthodontic treatment, common pathological changes are gingivitis,
      bleeding and gingival growth; thus, gingival index and plaque index parameters have been used
      as indicators of periodontal disease in many studies. Enamel demineralization which results
      in white spot formation is observed due to the increase in the number and volume of
      acid-producing bacteria, and the decrease in pH level because of the glucose metabolized by
      these cariogenic bacteria . The most commonly investigated bacteria among those mentioned
      above is Streptococcus Mutans. In the literature, it has been the subject of many studies,
      including those investigating the correlation between the S. mutans count and the amount of
      adhesive left between brackets and the enamel, adhesion of S. mutans to nickel titanium and
      copper-nickel brackets, the difference in S. mutans colonization between self-ligation system
      and normal brackets, and the effect of elastomeric rings and ligature wires on S. mutans
      colonization.

      Non-conventional elastomeric ligatures were produced in order to reduce the friction of
      orthodontic sliding mechanics. Manufacturers claim that non-conventional elastomeric
      ligatures reduced ligation friction by 60% compared to conventional modules. It was reported
      in another study that brackets combined via non-conventional elastomeric ligatures resulted
      in a reduced friction force compared to conventional elastomeric ligatures in any wires from
      14-inch NITI to 19.25 SS.

      To our current knowledge, bacterial colonization on non-conventional elastomeric ligatures
      was investigated in one study only, using microbial culture technique. In light of this
      information, present study was aimed to compare S. mutans colonization among different
      commercial types of non-conventional ligatures and ligature wires. The surface structures of
      these ligature types also will be investigated by atomic force microscope (AFM) and the
      results of this investigation will be associated with the results of bacterial colonization
      amount.
    

Intervention name(s): Leone slide low friction elastomeric ligature; RMO tough - o energy elastomeric ligature; Dentsply sili tie elastomeric ligature; AO twisted ended ligature wire
Intervention type(s): Other; Other; Other; Other
Intervention description(s): Leone slide low friction elastomeric ligature application; RMO tough - o energy elastomeric ligature application; Dentsply sili tie elastomeric ligature application; AO twisted ended ligature wire application
Allocation: Non-Randomized
Intervention model: Crossover Assignment
Intervention model description: 2 a cross-over, in vivo study.
Masking: Single (Outcomes Assessor)
Primary purpose: Basic Science
Keywords: bacterial adhesion; elastomeric ligatures