The effect of different oral hygiene regimens on the quantity of cariogenic plaque on orthodontic bands with different attachments (A clinical photographic study)

Abstract

Background: Fixed orthodontic appliances impede the maintenance of oral hygiene and result in plaqueaccumulation leads to enamel demineralization caused by acids produced by bacteria. Studies on plaque controlstrategies in orthodontic populations are limited. This might be caused by difficulties in the quantitative evaluation ofdental plaque because the teeth have various levels of bracket coverage, and different tooth sizes andmalocclusions, making the traditional categorical indices complex. The present study aims to evaluate the effect ofdifferent hygiene protocols on plaque quantity on bands with different attachments.Materials and method: Twenty patients had four bands within the orthodontic appliance. Then randomly divided intofour groups of hygiene regimens where group A used chlorhexidine dentifrice, group B used fluoridated dentifrice,group C used chlorhexidine mouthwash along with chlorhexidine dentifrice and group D used chlorhexidinemouthwash in addition to the fluoride dentifrice. Bands were removed four weeks after the appliance been in place,cut out carefully into 2 pieces from the center of the mesial and distal contact areas, biochemical test (clinprocarioL-pop) was applied then 80 digital photographs were obtained. Four areas of interest were estimated which aremesially and distally to each attachment (2 mm) in width each. Percentage of plaque in these areas was calculatedand statistically analyzed.Results: Side difference revealed that the plaque accumulated on the right sided bands more than the left, howeverthe difference was not significant. It was also found that the lower bands had insignificantly higher amount of plaquethan the upper ones.Conclusions: The four groups of oral hygiene regimens have no significant different effects on the plaque amount.Moreover, the oral hygiene maintenance is more difficult in the right side than the left side but the difference was notsignificant. The lower arch accumulated insignificantly more plaque than the upper. Also, difference in attachmentshas no influence on plaque amount