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The microbial changes in subgingival plaques of orthodontic patients: a systematic review and meta-analysis of clinical trials
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The microbial changes in subgingival plaques of orthodontic patients: a systematic review and meta-analysis of clinical trials
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Journal Article
The microbial changes in subgingival plaques of orthodontic patients: a systematic review and meta-analysis of clinical trials
2017
Overview
Background
Orthodontic treatment was found to have an impact on the quantity and constitution of subgingival microbiota. However, contradictory findings regarding the effects of fixed appliances on microbial changes were reported. The aim of this systematic review was to investigate the microbial changes in subgingival plaques of orthodontic patients.
Methods
The PubMed, Cochrane Library, and EMBASE databases were searched up to November 20, 2016. Longitudinal studies observing microbial changes in subgingival plaques at different time points of orthodontic treatment are included. The methodological quality of the included studies was assessed by Methodological index for non-randomized studies (MINORS). The studies that reported the frequency of subgingival periodontopathogens were used for quantitative analysis. Other studies were analysed qualitatively to describe the microbial changes during orthodontic treatment.
Results
Thirteen studies were selected, including two controlled clinical trials, three cohort studies and eight self-controlled studies. Four periodontopathogens, including
Aggregatibacter actinomycetemcomitans
(
Aa
),
Porphyromonas gingivalis
(
Pg
),
Prevotella intermedia
(
Pi
) and
Tannerella forsythia
(
Tf
), were analysed. Following orthodontic appliance placement, the frequencies of
Pg
and
Aa
showed no significant change (
P
= 0.97 and
P
= 0.77), whereas the frequency of
Tf
significantly increased (
P <
0.01) during short-term observation (0–3 months). The frequency of
Pi
showed a tooth-specific difference, as it presented no significant difference (
P
= 0.25) at the site of the first molar but was significantly increased (
P
= 0.01) at the incisor. During long-term observation (> = 6 months), two studies reported that the levels of subgingival periodontopathogens exhibited a transient increase but decreased to the pretreatment levels afterwards. After removal of the orthodontic appliance, the four periodontopathogens showed no significant difference compared with before removal.
Conclusion
The levels of subgingival pathogens presented temporary increases after orthodontic appliance placement, and appeared to return to pretreatment levels several months later. This indicates that orthodontic treatment might not permanently induce periodontal disease by affecting the level of subgingival periodontal pathogen levels. Further studies of high methodological quality are required to provide more reliable evidence regarding this issue.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
