Prevenzione e igiene orale in pazienti in terapia ortodontico-chirurgica

Objectives

The aim of this work consists in presenting the results obtained from a qualitative and quantitative analysis of bacterial plaque in patients in orthodontic surgical treatment.

Materials and methods

Seventy-five patients of both sexes (aged 21–41 years) were studied. Samples of plaque were obtained from lingual surfaces of tooth 46 at the first appointment (T1), the day before surgical intervention (T2), during intermaxillary fixation (T3), at the removal of the orthodontic appliance (T4) and after one year from the removal of the fixed appliance (T5). Samples of plaque were evaluated quantitatively and qualitatively, analysing plaque index, total coccoid and bacillary forms and Gram positive and Gram negative forms for each sample.

Results

A slight decrease of the plaque index and total bacillary and coccoid forms between the first sample (T1) and the one taken the day before surgical intervention (T2) was recognised. During intermaxillary fixation (T3), a slight increase of the plaque index was evidenced. Between T3 and T4 another reduction of the plaque index (that reached 8%) was noticed. The plaque index was lower in T4 (8%) than in T2 (14%). From the fourth to the fifth sampling, performed after a year, there was a further general improvement of the plaque index: indeed, in 51 patients out of 75 (68%) the plaque index decreased, while in 24 patients there was a slight increase that did not exceed 10% compared with the previous sampling.

Conclusions

Patients in orthodontic surgical treatment, after a proper training, show a significant reduction of bacterial plaque between the first appointment and the following ones. Bacterial forms diminish. Also during intermaxillary fixation, when mechanical plaque control is compromised, it is possible to plan a plaque control through mouthwashes containing hydrolitic enzymes with destranasic activity.