title: Effects of Fixed and Removable Space Maintainers on Plaque Accumulation, Periodontal Health, Candidal and Enterococcus Faecalis Carriage.
abstract: OBJECTIVE
  To evaluate the effects of space maintainers on plaque accumulation, periodontal health and oral microflora.
  
  
  METHODS
  The study participants comprised 38 patients aged 4-10 years requiring either fixed or removable space maintainers. Plaque index, gingival index, bleeding on probing index, candidal colonization and Enterococcus faecalis were recorded just before the application of space maintainers (T0) and during treatment at the 1st (T1), 3rd (T2) and 6th (T3) month.
  
  
  RESULTS
  The gingival and bleeding on probing index scores increased significantly (gingival index from 0.20 ± 0254 to 0.54 ± 0417 and bleeding on probing index from 7.18 ± 9.946 to 18.07 ± 14.074) in the regions with fixed space maintainers at T3 (p < 0.01). The mean Candida counts also increased (for removable appliances from 1.90 ± 3.638 to 1.98 ± 3.318, p < 0.05, and for fixed appliances from 4.25 ± 4.587 to 4.52 ± 4.431, p < 0.001). The salivary E. faecalis counts at T3 also increased significantly with the use of fixed and removable appliances (for removable appliances from 5.93 ± 2.65 to 85.53 ± 34.1 and for fixed appliances from 4.95 ± 2.94 to 123.59 ± 29.51, p < 0.001). A positive correlation was found between the plaque (r = 0.67), gingival (r = 0.76) and bleeding on probing index scores (r = 0.76) and the candidal colonization for the fixed space maintainers (p < 0.01, p < 0.001).
  
  
  CONCLUSIONS
  In this study, both fixed and removable space maintainers led to an increase in the number of microorganisms in the oral cavity as well as to increases in the periodontal index scores. Patients should be informed that space maintainers may serve as a source of infection and that special attention must be given to their oral hygiene.
authors.affiliation: Department of Pedodontics, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Arikan
authors.forename: Esra
authors.initials: E
authors.lastname: Kizilci
authors.forename: Nurhan
authors.initials: N
authors.lastname: Ozalp
authors.forename: Berrin
authors.initials: B
authors.lastname: Ozcelik
mesh_terms: D002175:Candida / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D003773:Dental Plaque / Q000473:pathology*; D003774:Dental Plaque Index; D013293:Enterococcus faecalis / Q000302:isolation & purification*; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D008297:Male; D009910:Oral Hygiene; D009967:Orthodontic Appliances / Q000382:microbiology*; D009968:Orthodontic Appliances, Removable / Q000382:microbiology; D010512:Periodontal Index