title: Elastomeric-ligated vs self-ligating appliances: a pilot study examining microbial colonization and white spot lesion formation after 1 year of orthodontic treatment.
abstract: OBJECTIVE
  To (1) evaluate the use of adenosine triphosphate (ATP)-driven bioluminescence for quantification of total plaque bacteria in orthodontic patients, (2) compare plaque bacteria amounts at the bracket-tooth interface with use of elastomeric-ligated and self-ligating brackets after 1 year of orthodontic treatment, and (3) analyze formation of white spot lesions by photographic evaluation and laser-light fluorescence (DIAGNOdent).
  
  
  METHODS
  Thirteen subjects had fixed orthodontic appliances placed where lateral incisors were bonded with either elastomeric-ligated or self-ligating brackets. Plaque bacteria were collected from incisor surfaces after 1 year and quantified using plating methods and ATP-driven bioluminescence. White spot lesions were evaluated by photographic and DIAGNOdent determinations. A 2 x 2 x 2 mixed-design ANOVA was conducted to determine differences in plaque retention between elastomeric-ligated and self-ligating brackets.
  
  
  RESULTS
  ATP-driven bioluminescence values correlated to numbers of total plaque bacteria (r = 0.80). However, unlike findings published in the original pilot study, which described increased plaque retention with elastomeric-ligated brackets at 5 weeks postbonding, there were no significant differences in bacterial numbers or ATP-driven bioluminescence values surrounding the elastomeric-ligated vs self-ligating brackets after 1 year of orthodontic treatment. Based on photographic and DIAGNOdent determinations, white spot lesions were found relatively equally on teeth bonded with either bracket type. DIAGNOdent measurements were found to have moderate sensitivity (0.71) and good specificity (0.88) when compared to white spot lesions determined using photographic evaluation.
  
  
  CONCLUSIONS
  ATP-driven bioluminescence can be used as an accurate assessment of total plaque bacteria in orthodontic patients. After 1 year of orthodontic treatment for patients in this pilot study, there appeared to be no differences in retention of plaque bacteria or white spot lesions comparing the bracket types. The use of DIAGNOdent has some limitations, but may prove to be useful to monitor white spot lesions longitudinally.
authors.affiliation: Department of Orthodontics, Oregon Health & Science University, School of Dentistry, Portland, Oregon 97239, USA.
authors.forename: Tyson
authors.initials: T
authors.lastname: Buck
authors.forename: Peter
authors.initials: P
authors.lastname: Pellegrini
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sauerwein
authors.forename: Michael C
authors.initials: MC
authors.lastname: Leo
authors.forename: David A
authors.initials: DA
authors.lastname: Covell
authors.forename: Tom
authors.initials: T
authors.lastname: Maier
authors.forename: Curtis A
authors.initials: CA
authors.lastname: Machida
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000293:Adolescent; D000704:Analysis of Variance; D001419:Bacteria / Q000378:metabolism; D002648:Child; D003731:Dental Caries / Q000209:etiology* / Q000382:microbiology; D003732:Dental Caries Activity Tests / Q000379:methods*; D003773:Dental Plaque / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D003774:Dental Plaque Index; D020724:Elastomers; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor; D008163:Luminescent Measurements; D016382:Orthodontic Appliance Design; D016910:Orthodontic Brackets / Q000009:adverse effects* / Q000145:classification / Q000382:microbiology; D010865:Pilot Projects; D017001:Tooth Demineralization / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control
chemical_list: D020724:Elastomers; D000255:Adenosine Triphosphate