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Abstract(s)
Introdução: Os alinhadores transparentes surgiram como alternativa aos aparelhos
fixos, e, parecem causar menos alteração no microbioma oral. Desta forma, o seu
contributo em alterações clínicas como cárie dentária e doença periodontal é menor. Esta
revisão tem como objetivo avaliar a evidência científica que reporta alterações ocorridas
no microbioma oral durante o tratamento ortodôntico e analisar as suas implicações ao
nível cariogénico e periodontal.
Material e métodos: A revisão sistemática utilizou as bases de dados do National
Institute of Health, Cochrane Library e Web of Science. Foram realizadas diversas
pesquisas com termos MeSH. Dois autores selecionaram os estudos de forma
independente e extraíram os dados de acordo com o método PRISMA respondendo à
questão PICO. A pesquisa foi realizada no período entre 2000 e 2021 e inclui estudos que
abordem alinhadores transparentes e as respetivas listagens de microrganismos presentes
na cavidade oral.
Resultados: Foram incluídos oito artigos no total, quatro deles abordam alterações
no microbioma oral com tratamento ortodôntico fixo e alinhadores transparentes e os
restantes apenas com alinhadores transparentes. Pacientes que utilizam aparelhos fixos
são mais propensos a bactérias cariogénicas (Streptococcus e Lactobacillus) e os
alinhadores transparentes despoletam menor quantidade de bactérias periodontais
(Porphyromonas e Fusobacterium). Os géneros Neisseria e Bacillus encontram-se
aumentados em utilizadores de alinhadores transparentes, o que sugere que contribuem
para a manutenção da saúde oral.
Conclusão: Parece haver evidência que pacientes que utilizam aparelhos fixos são
mais propensos a bactérias cariogénicas e que os alinhadores transparentes apresentam
menos patogenos periodontais, assim, os alinhadores transparentes são menos propensos
a desenvolverem doenças periodontais graves em comparação com os aparelhos fixos.
Tal facto pode ser justificado pela natureza removível do alinhador e desse modo facilitar
a higienização. No entanto, mais estudos, com maior número de pacientes, maior duração
e menor heterogeneidade são necessários para conclusões mais sólidas.
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.
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.
Description
Keywords
Alinhadores transparentes Alinhadores termoplásticos Invisalign® Microbioma Bactéria Clear aligners Thermoplastic aligners Microbiome Bacteria