Evolução do microbioma oral durante o tratamento ortodôntico com alinhadores transparentes

Abstract

Introduction: Clear aligners emerged as an alternative to fixed appliances, and seem to cause less change in the oral microbiome. Thus, its contribution to clinical changes such as tooth decay and periodontal disease is smaller. This review aims to assess the scientific evidence that reports changes in the oral microbiome during orthodontic treatment and analyze their implications at the cariogenic and periodontal level. Material and methods: The systematic review used the National Institute of Health, Cochrane Library and Web of Science databases. Several searches were carried out with MeSH terms. Two authors selected the studies independently and extracted the data according to the PRISMA method answering the PICO question. The survey was conducted between 2000 and 2021 and includes studies that address clear aligners and the respective listings of microorganisms present in the oral cavity. Results: Eight articles were included in total, four of them addressing changes in the oral microbiome with fixed orthodontic treatment and clear aligners and the remaining only with clear aligners. Patients using fixed appliances are more prone to cariogenic bacteria (Streptococcus and Lactobacillus) and clear aligners trigger less periodontal bacteria (Porphyromonas and Fusobacterium). The genera Neisseria and Bacillus are increased in users of clear aligners, which suggests that they contribute to the maintenance of oral health. Conclusion: There seems to be evidence that patients using fixed appliances are more prone to cariogenic bacteria and that clear aligners have fewer periodontal pathogens; thus, clear aligners are less likely to develop serious periodontal disease compared to fixed appliances. This fact can be justified by the removable nature of the aligner and thus facilitate cleaning. However, more studies, with a larger number of patients, longer duration and less heterogeneity are needed for more solid conclusions.

Date of Award	29 Jul 2021
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Maria José Correia (Supervisor), Ana Sofia Duarte (Co-Supervisor) & Pedro Lopes (Co-Supervisor)