Investigation of the general state of oral hygiene in patients undergoing orthodontic treatment

   Relevance. In patients with orthodontic structures, plaque accumulating for a long time around a non-removable device can lead to enamel demineralization, rapidly progressing to a carious cavity and the development of gingival inflammation. An important aspect of the management of such patients is measures to reduce the risk of caries and improve the effectiveness of oral hygiene.

   The aim of the study was to assess the level of oral hygiene in patients undergoing orthodontic treatment in groups with different methods of enamel preparation before fixing braces.

   Materials and methods. A randomized, controlled trial was conducted involving 60 patients aged 18–30 years. To assess the level of oral hygiene and the intensity of caries, we determined: the DMF index, the index of oral hygiene of OHI-S. The assessment of the enamel condition after removal of braces was carried out using the Adhesive Remnant Index (ARI). Universal Bond adhesive system (Tokuyama Dental), SHIELD FORCE PLUS varnish (Tokuyama Dental), double-curing adhesive fixing cement ESTECEM PLUS (Tokuyama Dental) were used to fix the braces. The effectiveness of oral hygiene was evaluated before treatment and 12 months after the start of orthodontic treatment.

   Results. There was a statistically significant decrease in the index of ОНІ-S in patients with ceramic and metal braces, the enamel surface of which was treated with varnish. The index of ОНІ-S before the start of the study in patients with ceramic braces was 1.5 ± 0.12, with metal ones – 1.4 ± 0.47. After 12 months, the index values were 1.6 ± 0.36 and 1.5 ± 0.46, respectively, p = 0.002. In the group of patients whose surface was not treated with varnish, the index values were statistically not significant, p > 0.05. When assessing the resistance of teeth to the development of caries using the DMF index, a statistically significant difference was also found in groups where bracket systems were fixed with pretreatment of the enamel surface with varnish. The value of the DMF index before the start of the study in the group of patients with ceramic braces was 1.7 ± 0.22, in the group with metal braces – 1.4 ± 0.14. After 12 months, the index values were 1.8±0.16 and 1.5 ± 0.23, respectively, p = 0.0012.

   Conclusion. The use of varnish before fixing braces helps to improve the condition of the oral cavity, which is expressed in improved hygiene, as well as in the absence of pathological changes on the enamel surface in the form of demineralization. In this regard, further studies are needed to assess the degree of influence of varnishes on the condition of the oral cavity in patients undergoing orthodontic treatment.

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