Impact of Fixed Orthodontic Appliances on Oral Microbiome Diversity: A Longitudinal Study
DOI:
https://doi.org/10.65293/jbkcd.v3i01.48Keywords:
Fixed Orthodontic Appliances, Oral Microbiome, Shannon Index, Oral Hygiene, Dietary Sugar, Longitudinal StudyAbstract
Background: Fixed orthodontic appliances can modify the oral environment, potentially influencing microbial diversity and oral health. This study sought to assess alterations in oral microbiome diversity over the course of one year and find related factors.
Study Design: Cross-sectional study
Place and Duration of the Study: Orthodontics Department of Rehman College of Dentistry, Peshawar, Pakistan, from January to June 2024.
Materials and Methods: A 12-month longitudinal study was conducted on 215 orthodontic patients. Oral samples were collected at baseline, 3, 6, and 12 months and analysed by 16S rRNA sequencing (Illumina MiSeq). The Shannon diversity index was used to quantify microbial diversity. Linear mixed models examined predictors of diversity change.
Results: Microbial diversity declined from 3.45 ± 0.55 to 2.95 ± 0.58 (β = –0.18, 95% CI: –0.30 to –0.06, p = 0.004). Reduced brushing frequency, high sugar intake, and prolonged appliance duration were significantly associated with lower diversity.
Conclusion: The variety of the oral microbiome diminishes progressively throughout fixed orthodontic treatment, with oral hygiene practices, dietary sugar consumption, and appliance duration serving as significant influencing variables. Highlighting efficient brushing and food regulation may assist in alleviating microbiota changes in orthodontic patients.
References
1. Lombardo G, Vena F, Negri P, Pagano S, Barilotti C, Paglia L, et al. Worldwide prevalence of malocclusion in the different stages of dentition: A systematic review and meta-analysis. Eur J Paediatr Dent [Internet]. 2020;21(2):115–22. Available from: http://dx.doi.org/10.23804/ejpd.2020.21.02.05
2. Blatz MB, Chiche G, Bahat O, Roblee R, Coachman C, Heymann HO. Evolution of aesthetic dentistry. J Dent Res [Internet]. 2019;98(12):1294–304. Available from: http://dx.doi.org/10.1177/0022034519875450
3. Cenzato N, Occhipinti C, D’amici E, Savadori P, Baldini B, Maspero C. Microbiological analysis of plaque and its composition in three patient groups under different orthodontic treatments. Dent J [Internet]. 2024;12(6):168. Available from: http://dx.doi.org/10.3390/dj12060168
4. Diab RA, Yap AU, Gonzalez MAG, Yahya NA. Impact of light-curing distance on the effectiveness of cure of bulk-fill resin-based composites. Saudi Dent J [Internet]. 2021;33(8):1184–9. Available from: http://dx.doi.org/10.1016/j.sdentj.2021.01.003
5. Huang J, Yao Y, Jiang J, Li C. Effects of motivational methods on oral hygiene of orthodontic patients: A systematic review and meta-analysis. Medicine (Baltimore) [Internet]. 2018;97(47):e13182. Available from: http://dx.doi.org/10.1097/md.0000000000013182
6. Palomares NB, Celeste RK, Oliveira B, Miguel JA. How does orthodontic treatment affect young adults’ oral health-related quality of life? Am J Orthod Dentofac Orthop [Internet]. 2021;141(6):751–8. Available from: http://dx.doi.org/10.1016/j.ajodo.2022.01.015
7. Julien KC, Buschang PH, Campbell PM. Prevalence of white spot lesion formation during orthodontic treatment. Angle Orthod [Internet]. 2013;83(4):641–7. Available from: http://dx.doi.org/10.2319/071712-584.1
8. Tufekci E, Dixon JS, Gunsolley JC, Lindauer SJ. Prevalence of white spot lesions during orthodontic treatment with fixed appliances. Angle Orthod [Internet]. 2011;81(2):206–10. Available from: http://dx.doi.org/10.2319/051710-262.1
9. Zhong W, Liang J, Wu Z, Zhang Y, Liu H, Li P. Expert consensus on orthodontic treatment of patients with periodontal disease. Int J Oral Sci [Internet]. 2025;17. Available from: http://dx.doi.org/10.1038/s41368-025-00356-W.
10. Brown MD, Campbell PM, Schneiderman ED, Buschang PH. A practice-based evaluation of the prevalence and predisposing etiology of white spot lesions. Angle Orthod [Internet]. 2016;86(2):181–6. Available from: http://dx.doi.org/10.2319/041515-249.1
11. Jing D, Hao J, Shen Y, Tang G, Lei L, Zhao Z. Effect of fixed orthodontic treatment on oral microbiota and salivary proteins. Exp Ther Med [Internet]. 2019; Available from: http://dx.doi.org/10.3892/etm.2019.7401
12. Sun F, Ahmed A, Wang L, Dong M, Niu W. Comparison of oral microbiota in orthodontic patients and healthy individuals. Microb Pathog [Internet]. 2018;123:473–7. Available from: http://dx.doi.org/10.1016/j.micpath.2018.08.011
13. Topaloglu-Ak A, Ertugrul F, Eden E, Ates M, Bulut H. Effect of orthodontic appliances on oral Microbiota—6 month follow-up. J Clin Pediatr Dent [Internet]. 2011;35(4):433–6. Available from: http://dx.doi.org/10.17796/jcpd.35.4.61114412637mt661
14. Al-lehaibi W kh, Al-makhzomi KA, Mohammed HS, Enezei HH, Alam MK. Physiological and immunological changes associated with oral Microbiota when using a thermoplastic retainer. Molecules [Internet]. 2021;26(7):1948. Available from: http://dx.doi.org/10.3390/molecules26071948
15. Gizani S, Petsi G, Twetman S, Caroni C, Makou M, Papagianoulis L. Effect of the probiotic bacteriumLactobacillus reuterion white spot lesion development in orthodontic patients. Eur J Orthod [Internet]. 2016;38(1):85–9. Available from: http://dx.doi.org/10.1093/ejo/cjv015
16. Wang Q, Ma J-B, Wang B, Zhang X, Yin Y-L, Bai H. Alterations of the oral microbiome in patients treated with the Invisalign system or with fixed appliances. Am J Orthod Dentofacial Orthop [Internet]. 2019;156(5):633–40. Available from: http://dx.doi.org/10.1016/j.ajodo.2018.11.017
17. He W, Zhao S, Liu X, Dong S, Lv J, Liu D. ReSeqTools: an integrated toolkit for large-scale next-generation sequencing based resequencing analysis. Genet Mol Res [Internet]. 2024;12(4):6275–83. Available from: http://dx.doi.org/10.4238/2013
18. Ghijselings E, Coucke W, Verdonck A, Teughels W, Quirynen M, Pauwels M, et al. Long‐term changes in microbiology and clinical periodontal variables after completion of fixed orthodontic appliances. Orthod Craniofac Res [Internet]. 2014;17(1):49–59. Available from: http://dx.doi.org/10.1111/ocr.12031
19. Östberg A-L, Halling A, Lindblad U. Gender differences in knowledge, attitude, behavior and perceived oral health among adolescents. Acta Odontol Scand [Internet]. 1999;57(4):231–6. Available from: http://dx.doi.org/10.1080/000163599428832
20. Bock NC, Von Bremen J, Schulz-Weidner KK, Ganss N. White spot lesions after fixed appliance treatment - is long-term improvement expected? Eur J Orthod [Internet]. 2023;45(5). Available from: http://dx.doi.org/10.1093/ejo/cjad070
21. Lucchese A, Gherlone E. Prevalence of white-spot lesions before and during orthodontic treatment with fixed appliances. Eur J Orthod [Internet]. 2013;35(5):664–8. Available from: http://dx.doi.org/10.1093/ejo/cjs070
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Journal of Bacha Khan College of Dentistry

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


