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Clinical and Microbiological Evaluation of Stabilised Periodontal Patients Undergoing Early Stage of Orthodontic Treatment

Original article

Abstrak

Rawatan ortodontik boleh menjejaskan keseimbangan mikrobiota oral yang memainkan peranan utama dalam etiologi penyakit periodontium. Kajian klinikal prospektif ini bertujuan untuk menilai kesihatan periodontal dan profil mikrobiologi pesakit periodontal yang sihat (Kumpulan 1) dan yang telah stabil (Kumpulan 2) selama tiga bulan pertama semasa rawatan ortodontik. Aplian ortodontik atas dan bawah tetap dipasang. Kesihatan periodontium dinilai menggunakan skor plak (PS), pendarahan pada probing (BOP) dan kedalaman poket (PD). 29 tapak telah diambil untuk persampelan plak subgingival. Sampel plak diinokulasikan pada agar Trypticase Soya Darah (TSBA) dan agar Trypticase Soya Bacitracin Vancomycin (TSBV) untuk penilaian aerob, anaerob, bakteria berpigmen hitam (BPH) dan Aggregatibacter actinomycetemcomitans. Semua ukuran diambil sebelum pendakap gigi dipasang (T0), 1 minggu (T1), 1 bulan (T2) dan 3 bulan selepas dipasang pendakap gigi (T3). Secara umumnya, kesihatan periodontium dalam kedua-dua kumpulan hampir sama. Selepas 1 minggu, bilangan aerob adalah lebih tinggi dalam Kumpulan 1 (88%) manakala anaerob adalah lebih tinggi dalam Kumpulan 2 (45%). A. actinomycetemcomitans lebih tinggi dalam Kumpulan 1 pada T0 dan T1 tetapi jauh lebih tinggi dalam Kumpulan 2 di T3. BPH adalah minimal pada setiap masa dengan tiada perbezaan signifikan. Oleh itu, semasa 3 bulan pertama rawatan ortodontik dijalankan, terdapat perubahan ketara dalam bilangan aerob-anaerob pada kedua-dua pesakit periodontal yang sihat dan stabil. Bakteria patogenik akan meningkat semasa rawatan awal ortodontik.

Abstract

Orthodontic treatment may affect the equilibrium of oral microbiota which plays a major role in aetiology of periodontal disease. This prospective clinical study aimed to assess the periodontal health and microbiological profile of healthy (Group 1) and stabilised periodontal (Group 2) patients throughout three months of orthodontic treatment. Upper and lower fixed orthodontic appliances were bonded. Periodontal health was assessed using plaque score (PS), bleeding on probing (BOP) and pocket depth (PD). 29 sites were taken for subgingival plaque sampling. Plaque samples were inoculated on Trypticase Soy Blood Agar (TSBA) and Trypticase Soy Bacitracin Vancomycin (TSBV) agar for assessment of aerobe, anaerobe, black pigmented bacteria (BPB) and Aggregatibacter actinomycetemcomitans. All the measurements were taken before bonding (T0), 1 week (T1), 1 month (T2) and 3 months post-bonding (T3).  Generally, periodontal health in both groups were almost similar. After 1 week, the number of aerobes was significantly higher in Group 1 (88%) while the anaerobes were significantly higher in Group 2 (45%). A. actinomycetemcomitans was higher in Group 1 at T0 and T1 but was significantly higher in Group 2 at T3. BPB was minimal at all time with no significant difference. Thus, during the first 3-month of orthodontic treatment, there were significant changes in the number of aerobes-anaerobes in both healthy and stabilised periodontal patients. Pathogenic bacteria would increase during early treatment of orthodontics.