THE INFLUENCE OF REMOVABLE AND NON-REMOVABLE ORTHODONTIC APPLIANCES ON THE ORAL MICROBIOCENOSIS, THE STATE OF HARD DENTAL TISSUES AND PERIODONTAL TISSUES IN CHILDREN AND ADOLESCENTS

Abstract

Dentomaxillary anomalies (DMA) occupy a leading place in the structure of dental pathology in children and adolescents, covering from 50% to 70% of the population. Despite the significant prevalence, the effectiveness of existing therapeutic and preventive measures remains insufficient, which is confirmed by the high rates of caries and periodontal diseases in this category of patients. The influence of orthodontic treatment on the microecology of the oral cavity attracts special scientific and practical attention. It has been established that the use of both removable and fixed appliances significantly transforms the biocenosis, creating conditions for the rapid formation of microbial biofilm. Purpose of the study. To assess the impact of removable and non-removable orthodontic appliances on the microbiocenosis of the oral cavity, the condition of hard dental tissues and periodontal tissues in children and adolescents. Materials and methods of the study. A clinical and microbiological study was conducted among children and adolescents aged 10–16 years who underwent orthodontic treatment. Patients were divided into two groups: with removable (plate appliances, trainer systems) and non-removable (bracket systems) appliances. The hygiene index (OHI-S), gingival bleeding index (PBI), the condition of hard dental tissues, the level of Streptococcus mutans in saliva and plaque were assessed. The study was conducted in dynamics: before the start of treatment, after 2, 4 and 8 weeks. For microbiological studies, methods of quantitative culture and identification of microorganisms were used. Results of the study. Hygienic condition: The use of fixed structures leads to a critical deterioration of hygiene. The dental plaque index in the group with braces increased from 1.2 ± 0.2 to 2.5 ± 0.4 in 8 weeks ($p < 0.05$), while when using removable appliances, the dynamics were moderate (up to 1.5 ± 0.3). Microbiological indicators: In patients with braces, a rapid increase in the level of Streptococcus mutans was observed - from 0.9 ± 0.2×10³ to 4.2 ± 0.9×10³ CFU/ml, which is 2.5 times higher than in the group with removable appliances. Inflammatory processes: The incidence of catarrhal gingivitis in the group with non-removable systems increased 5.5 times (from 6 to 33 people), which correlates with plaque accumulation and microbial colonization. Conclusions. The obtained data emphasize the need to develop individualized prevention strategies and enhanced hygienic control, especially when using fixed orthodontic appliances, which requires close interdisciplinary interaction between the orthodontist and hygienist