An In-Vitro Evaluation of Microbial Adhesion on Different Types of Orthodontic Brackets

Introduction: Information regarding the adhesion of bacterial species and plaque accumulation to bracket material is limited. Adequate information is needed in order to offer patients orthodontic treatment without significantly increasing their risk of developing white spots, caries, or gingival inflammation. Aim: To determine the levels of the caries-inducing S. mutans species on metallic, self-ligating and ceramic brackets and to compare the total bacterial counts and counts of species present on these bracket materials. Materials and Methods: By means of an in-vitro study, six commercially available bracket systems {3M Gemini (A), American Ortho (B), Ormco (C), Begg (D), Ceramic (E) and Self-ligating (F)} were compared. The brackets were bonded in the cell well culture plate and the agar plates were prepared. Brain heart infusion medium including bacteria and artificial saliva was introduced to each bracket system containing 10 premolar brackets and were incubated. After 72 hours, the adherent bacteria were then detached by sonication and the Colony-Forming Units (CFU) of Streptococcus mutans were calculated on each bracket and were analysed using Statistical Package for the Social Sciences (SPSS) software version 17.0 for Windows. Results: Between the different bracket types, significant differences were found in terms of biofilm formation. The Begg brackets showed the least bacterial adhesion and the selfligating brackets showed the highest bacterial adhesion and was statistically significant among all the groups (p<0.05). Ceramic brackets also showed a higher bacterial adhesion after the self-ligating brackets. Among the three groups of metallic brackets, 3M brackets showed the least bacterial adhesion but was statistically insignificant (p>0.05). Conclusion: Different orthodontic brackets serve as different loci for biofilm formation showing that the Begg brackets are the most hygienic among all the brackets taken in this study