Effect of different bracket types on streptococcus mutans count in orthodontic patients using fluoridated toothpaste

Background: Plaque retention during fixed orthodontic therapy is an important cause of developing enamel demineralization. The purpose of this study was to evaluate the effect of different brackets types on the count of Streptococcus Mutans in orthodontic patients using conventional fluoridated toothpaste. Materials and Methods: Plaque samples were collected from maxillary 1st premolar teeth of twenty right handed patients (using split mouth technique) before bonding, after 48 hrs of bonding using tooth brush only, and after 2 weeks of using fluoridated toothpaste. Stainless steel bracket was bonded on right first premolar while the left one was bonded with sapphire bracket. The calculation of the Streptococcus Mutans count was done using the plate counting method utilizing colony counter. The differences between the two types of brackets were determined using the Wilcoxon signed ranks test. Results: The median bacterial count on the right side was insignificantly higher than the left side; streptococcus mutans in the plaque sample around the sapphire brackets showed insignificantly less counts than around the stainless steel one, when the patients used tooth brush only or fluoridated toothpastes. Fluoridated toothpastes reduced streptococcus mutans insignificantly around both types of brackets. Conclusion: Fluoridated toothpaste acts effectively in reducing streptococcus mutans colony counts around sapphire and stainless steel brackets. Keywords: Streptococcus mutans, Stainless steel brackets, Sapphire brackets.

The Transmission of Anaerobic Periodontopathic Organisms

The oral microbial flora is unique, and available evidence indicates that it is passed vertically from parents to children. In this investigation, we used a chairside assay for the N-benzoyl-DL-arginine-2-naphthylamide (BANA)-sensitive enzyme found in Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythensis, to determine the prevalence of these BANA-positive species in young children and their caregivers. We predicted that if the BANA enzyme was found in plaque samples of children, it would also be present in the plaque samples of the caregivers. Forty-four percent of 150 children had at least one plaque sample positive for the BANA enzyme. If the caregiver was BANA-positive, the odds of the child also being BANA-positive was 35 times more than for a child with a BANA-negative caregiver, after adjustment for the child’s age and papillary bleeding score (PBS). Other significant predictors were the PBS of children (p < 0.001), a history of periodontal disease, and the ages of the caregivers (p < 0.001).

The Utility of the BANA Test for Monitoring Anaerobic Infections due to Spirochetes (Treponema denticola) in Periodontal Disease

Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus each possesses an enzyme(s) that hydrolyzes the synthetic substrate benzoyl-DL-arginine-naphthylamide (BANA). The presence of these organisms in a subgingival plaque sample can be determined by the ability of the plaque to hydrolyze BANA. In the present study, we describe the usefulness of the BANA test at various stages of a clinical trial of the efficacy of metronidazole in the treatment of periodontal disease. A BANA-positive test was significantly associated with high levels and proportions of spirochetes in the plaque, so that it provided information comparable with that which could be obtained by a microscopic examination of the plaque. Patients with such anaerobic spirochetal infections were randomly assigned to a group receiving either metronidazole or placebo (250 mg, three times a day) for one week and whose teeth were scaled and root-planed. The advantages of the decision that metronidazole be used were apparent from the comparison with the results obtained in the patients who received only the scaling and root planing. The initially BANA-positive teeth in the patients treated with metronidazole, scaling, and root planing gained attachment and exhibited a significant reduction in the need for periodontal surgery, when compared with the BANA-positive teeth in the patients who received only placebo, scaling, and root planing. After the conclusion of this therapy, those teeth with persistent BANA-positive plaques had significantly higher proportions and levels of spirochetes than did the teeth with BANA-negative plaques. A tooth site which tested BANA-positive after the initial therapy lost significantly more attachment in the year following active treatment than did a tooth site that tested BANA-negative, i.e., a mean difference of 0.48 mm per year. The ability of the BANA test to detect an anaerobic infection due to the BANA-positive species and possibly to predict future attachment loss indicates that this test may be helpful in the management of the periodontally diseased patient.