تاثیر ﺳﻪ ﻧوع براکت ارتودنسی فلزی، سرامیکی و self ligating بر میزان چسبندگی استرپتوکوک موتانس

سابقه و هدف: ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﮔﺴﺘﺮش درﻣﺎن ﻫﺎی ارﺗﻮدﻧﺴﻰ و ﺗﻐﻴﻴﺮ ﻓﻠﻮر دﻫﺎن ﻣﺘﻌﺎﻗﺐ درﻣﺎن ارﺗﻮدﻧﺴﻰ و در ﻧﺘﻴﺠﻪ اﻓﺰاﻳﺶ ﺑﺮوز ﺿﺎﻳﻌﺎت ﺳﻔﻴﺪ ﻣﻴﻨﺎﻳﻰ در ﺑﻴﻤﺎران ﺗﺤﺖ درﻣﺎن ارﺗﻮدﻧﺴﻰ و وﺟﻮد آﻣﺎر ﻣﺘﻨﺎﻗﺾ ﭘﻴﺮاﻣﻮن ﺗﺎﺛﻴﺮ نوع ﺑﺮاﻛﺖ ﻫﺎ ﺑﺮ ﻣﻴﺰان ﭼﺴﺒﻨﺪﮔﻰ ﻣﻴﻜﺮو ارﮔﺎﻧﻴﺰم ﻫﺎ، اﻳﻦ ﺗﺤﻘﻴﻖ ﺑﺎ ﻫﺪف ﻣﻘﺎﻳﺴﻪ ﺗﺎﺛﻴﺮ ﺳﻪ ﻧﻮع ﺑﺮاﻛﺖ ارﺗﻮدﻧﺴﻰ (ﻓﻠﺰی، ﺳﺮاﻣﻴﻜﻰ و selfligating) ﺑﺮ ﻣﻴﺰان رﺷﺪ و ﭼﺴﺒﻨﺪﮔﻰ اﺳﺘﺮﭘﺘﻮﻛﻮک ﻣﻮﺗﺎﻧﺲ اﻧﺠﺎم ﺷﺪ.مواد و روش ها: ﺗﺤﻘﻴﻖ ﺑﻪ روش تجربی و ﺗﺤﺖ ﺷﺮاﻳﻂ in vitro ﺑﺮ روی ٦٠ ﻧﻤﻮﻧﻪ اﻧﺠﺎم ﺷﺪ. ﺳﻪ ﻧﻮع ﺑﺮاﻛﺖ ﻓﻠﺰی، ﺳﺮاﻣﻴﻜﻰ و selfligating ﻣﺮﺑﻮط ﺑﻪ دﻧﺪان ﭘﺮه ﻣﻮﻟﺮ ﺑﻪ ﻣﻨﻈﻮر ﻣﻘﺎﻳﺴﻪ ﭼﺴﺒﻨﺪﮔﻰ اﺳﺘﺮﭘﺘﻮﻛﻮک ﻣﻮﺗﺎﻧﺲ ﻣﻮرد ﻣﻄﺎﻟﻌﻪ ﻗﺮار ﮔﺮﻓﺖ. ﻫﺮ ﻛﺪام از ﺑﺮاﻛﺖ ﻫﺎ درون ﭘﻠﻴﺖ ﻫﺎی ﺣﺎوی ١٥ ﺳﻰ ﺳﻰ از ﻣﺤﻴﻂ ﻛﺸﺖ ﻧﻮﺗﺮﻳﻨﺖ ﺑﺮاث اﺳﺘﺮﻳﻞ شده ﻫﻤﺮاه ﺑﺎ ٢٠% ﺳﻮﻛﺮوز ﻗﺮار داده ﺷﺪند. ﺳﭙﺲ ﺑﻪ ﻫﺮ ﻛﺪام از ﭘﻠﻴﺖ ﻫﺎ ٥ ﺳﻰ ﺳﻰ از ﺳﻮﺳﭙﺎﻧﺴﻴﻮن ﻣﻴﻜﺮوﺑﻰ ﺗﻬﻴﻪ ﺷﺪه اﺿﺎﻓﻪ ﺷﺪ. ﭘﻠﻴﺖ ﻫﺎ ﺑﻪ ﻣﺪت ٥ روز در اﻧﻜﻮﺑﺎﺗﻮر ٣٧ درﺟﻪ ﺳﺎﻧﺘﻰ ﮔﺮاد اﻧﻜﻮﺑﻪ ﺷﺪﻧﺪ. ﺳﭙﺲ ﺑﻌﺪ از ﺧﺎرج ﺳﺎزی ﻣﺤﻴﻂ ﻣﺎﻳﻊ ﻧﻮﺗﺮﻳﻨﺖ ﺑﺮاث از ﭘﻠﻴﺖ ﻫﺎ، ﭘﻠﻴﺖ ﻫﺎ ﺳﺮو ﺗﻪ ﺷﺪه و ﺗﻌﺪاد ﻛﻠﻮﻧﻰ ﻫﺎی ﭼﺴﺒﻴﺪه ﺑﻪ ﭘﻠﻴﺖ ﺑﻪ ﺻﻮرت ﭼﺸﻤﻰ ﺷﻤﺎرش ﺷﺪه و ﺑﺮ اﺳﺎس colony forming unit (cfu) ﺑﻴﺎن ﺷﺪﻧﺪ. در مرحله بعدی آزمایش به منظور تایید مرحله اول مطالعه براکت ها درون محیط بلود آگار قرار گرفته و کلونی های حاصل مورد شمارش قرار گرفته که نتایج حاصله از آن تایید کننده مرحله اول بود. داده ﻫﺎ ﺗﻮﺳﻂ آزﻣﻮن آﻣﺎری anova ﻣﻮرد ﻗﻀﺎوت ﻗﺮار گرفتند.یافته ها: ﺗﺤﻘﻴﻖ روی ٦٠ ﻧﻤﻮﻧﻪ ﺑﺮاﻛﺖ از ﺳﻪ نوع ﻓﻠﺰی، ﺳﺮاﻣﻴﻜﻰ و selfligating اﻧﺠﺎم ﺷﺪ. نتایج مطالعه نشان داد که ﺑﻴﺸﺘﺮﻳﻦ ﻣﻴﺰان ﭼﺴﺒﻨﺪﮔﻰ اﺳﺘﺮﭘﺘﻮﻛﻮک ﻣﻮﺗﺎﻧﺲ به ترتیب ﻣﺘﻌﻠﻖ ﺑﻪ ﺑﺮاﻛﺖ selfligating ﺑﻪ ﻣﻴﺰان 15.01 ± 51.25 و ﺑﻌﺪ ﺑﺮاﻛﺖ ﻓﻠﺰی ﺑﻪ ﻣﻴﺰان 7.1 ± 21.8 و ﺑﺮاﻛﺖ ﺳﺮاﻣﻴﻜﻰ ﺑﻪ ﻣﻴﺰان 3.6 ± 15.5 ﺑﻮد و تفاوت بین 3 گروه معنی دار بود (p<0.001). در ضمن نتایج حاصله با آزمایش نمو.نه ها در محیط کشت بلود اگار نیز تایید شد (p<0.01).ﻧﺘﻴﺠﻪ ﮔﻴﺮی: ﻣﻴﺰان رﺷﺪ و ﭼﺴﺒﻨﺪﮔﻰ اﺳﺘﺮﭘﺘﻮﻛﻮک ﻣﻮﺗﺎﻧﺲ در ﺣﻀﻮر ﺑﺮاﻛﺖ ﻫﺎی ارﺗﻮدﻧﺴﻰ ﺑﺎ ﺟﻨﺲ ﻫﺎ و ﻃﺮاﺣﻰ ﻫﺎی ﻣﺨﺘﻠﻒ، ﻣﺘﻔﺎوت اﺳﺖ. بیشترین چسپندگی اﺳﺘﺮﭘﺘﻮﻛﻮک ﻣﻮﺗﺎﻧﺲ متعلق به ﺑﺮاﻛﺖ selfligating و کمترین میزان چسپندگی متعلق به براکت سرامیکی بود.

Comparison of the effect of three types of metal, ceramic and self ligating orthodontic brackets on Streptococcus mutans adhesion

Background and Aim: With increasing demand for orthodontic treatment among adults and with changing oral flora and increased number of white spot lesions around orthodontic appliances in patients undergone orthodontic treatments and also with controversial reports about the role of different brackets types on adhesion of Streptococcus mutans, this study was aimed to compare the effect of different orthodontic bracket material and design (metal, ceramic, self ligating) on growth and adherence of streptococcus mutans.Materials and methods: This experimental in vitro study was accomplished on 60 premolar bracket samples. Three types of brackets (metallic, ceramic and selfligating) were used for comparison of streptococcus mutans adhesion. Each of the brackets was placed into small size plates containing 15cc of sterile Nutrient broth with %20 sucrose. Then 5cc of bacterial suspension were added to each plate. Plates were incubated for 5 days at 37 °C. Then, after removal of the nutrient broth liquid from plates, the plate was turned upside down and the number of colonies attached to the plate was counted by eye according to Colony forming unit (CFU). In order to confirm the results of the first phase of the study, the contaminated brackets were placed in the blood agar medium. The results of the second test confirmed the validity of the first step. Data were analyzed by ANOVA test.Results: The results of the study showed that the maximum streptococcus mutans adhesion was belonged to selfligating (51.25 ±15.01), followed by metal (21.8 ±7.1) brackets and there was lowest adhesion was to ceramic brackets (15.5 ±3.6) and the differences were statistically significant (p<0.001). The second stage of the study also confirmed the results of the first stage (p<0.01).Conclusion: The growth and adhesion of Streptococcus mutans is different in the presence of various orthodontics bracket material and bracket designs. In an in vitro setup, the selfligating metallic brackets showed higher adhesion and growth of Streptococcus mutans than conventional twin metal brackets, followed by Ceramic brackets.