Dental and Medical Problems

Dent Med Probl
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Dental and Medical Problems

2012, vol. 49, nr 1, January-March, p. 110–120

Publication type: review

Language: Polish

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

Zmiany mikroflory jamy ustnej podczas leczenia ortodontycznego aparatami stałymi – przegląd piśmiennictwa

Changes in Oral Microbiota During Fixed Orthodontic Treatment – A Literature Review

Tomasz Stefański1,, Aleksandra Myrda2,, Lidia Postek-Stefańska3,

1 Studenckie Koło Naukowe przy Katedrze i Zakładzie Stomatologii Wieku Rozwojowego Śląskiego Uniwersytetu Medycznego w Katowicach

2 Studium Doktoranckie przy Wydziale Lekarskim z O ddziałem Lekarsko-Dentystycznym w Zabrzu Śląskiego Uniwersytetu Medycznego w Katowicach

3 Katedra i Zakład Stomatologii Wieku Rozwojowego Śląskiego Uniwersytetu Medycznego w Katowicach

Streszczenie

Elementy ortodontycznych aparatów stałych w jamie ustnej stwarzają wiele potencjalnych powierzchni dla odkładania płytki bakteryjnej i utrudniają jej usuwanie. Zwiększone gromadzenie płytki wiąże się również ze zmianami naturalnej mikroflory. Na podstawie piśmiennictwa przedstawiono zmiany jakościowe i ilościowe zachodzące podczas leczenia ortodontycznego aparatami stałymi z uwzględnieniem bakterii kariogennych, periodontopatogennych oraz drobnoustrojów oportunistycznych, w tym grzybów. Omówiono także adhezję bakterii do różnych materiałów ortodontycznych i jej zależność od właściwości powierzchniowych tych materiałów. Z przeglądu piśmiennictwa wynika, że zmiany mikroflory jamy ustnej są w większości przypadków przejściowe. Mogą jednak prowadzić do powikłań nawet przy zachowaniu dobrej higieny. Jeśli chodzi o choroby przyzębia, to przy zachowaniu właściwej higieny jamy ustnej są to powikłania doraźne w postaci zapalenia dziąseł, które w niewielkim stopniu wpływają na przyszły stan tych tkanek. Białe plamy próchnicowe natomiast mogą stać się nieusuwalnymi bliznami, a w razie braku działań zapobiegawczych – przekształcić się w bardziej zaawansowane ubytki wymagające leczenia odtwórczego.

Abstract

Fixed orthodontic appliances in the mouth create a high number of plaque-retentive sites and impede plaque removal. An increased biofilm accumulation is associated with the shift of oral microbiological balance. This article reviews the qualitative and quantitative changes of cariogenic, and periodontopathogenic bacteria, as well as opportunistic microbes, including fungi. Furthermore, bacterial adhesion to different orthodontic materials is discussed with regard to their surface properties that influence microbial colonisation. On the basis of literature review it has been concluded that, in most cases, microbial changes are temporary. They may lead to complications. When a proper oral hygiene is maintained, the effect on periodontal health is transient, and gingivitis may occur. Microbial change have a little long-term detrimental impact on periodontal structures. Nevertheless, white spot lesions may remain as visible enamel scars or, if not treated, progress to cavitated lesions requiring restorative treatment.

Słowa kluczowe

leczenie ortodontyczne, aparaty stałe, bakterie, adhezja bakterii, płytka nazębna

Key words

orthodontic treatment, fixed appliances, bacteria, bacterial adhesion, dental plaque

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