تاثير ﺳﻪ ﻧوع براكت ارتودنسي فلزي، سراميكي و self ligating بر ميزان چسبندگي استرپتوكوك موتانس

Comparison of the Effect of Three Types of Metal, Ceramic and Self ligating Orthodontic Brackets on Streptococcus Mutans Adhesion

سابقه و هدف: ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﮔﺴﺘﺮش درﻣﺎن ﻫﺎي 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 (ﻓﻠﺰي، ﺳﺮاﻣﻴﻜﻰ و self-ligating) ﺑﺮ ﻣﻴﺰان رﺷﺪ و ﭼﺴﺒﻨﺪﮔﻰ اﺳﺘﺮﭘﺘﻮﻛﻮك ﻣﻮﺗﺎﻧﺲ اﻧﺠﺎم ﺷﺪ. مواد و روش ها: ﺗﺤﻘﻴﻖ ﺑﻪ روش تجربي و ﺗﺤﺖ ﺷﺮاﻳﻂ in vitro ﺑﺮ روي 60 ﻧﻤﻮﻧﻪ اﻧﺠﺎم ﺷﺪ. ﺳﻪ ﻧﻮع ﺑﺮاﻛﺖ ﻓﻠﺰي، ﺳﺮاﻣﻴﻜﻰ و self-ligating ﻣﺮﺑﻮط ﺑﻪ دﻧﺪان ﭘﺮه ﻣﻮﻟﺮ ﺑﻪ ﻣﻨﻈﻮر ﻣﻘﺎﻳﺴﻪ ﭼﺴﺒﻨﺪﮔﻰ اﺳﺘﺮﭘﺘﻮﻛﻮك ﻣﻮﺗﺎﻧﺲ ﻣﻮرد ﻣﻄﺎﻟﻌﻪ ﻗﺮار ﮔﺮﻓﺖ. ﻫﺮ ﻛﺪام از ﺑﺮاﻛﺖ ﻫﺎ درون ﭘﻠﻴﺖ ﻫﺎي ﺣﺎوي 15 ﺳﻰ ﺳﻰ از ﻣﺤﻴﻂ ﻛﺸﺖ ﻧﻮﺗﺮﻳﻨﺖ ﺑﺮاث اﺳﺘﺮﻳﻞ شده ﻫﻤﺮاه ﺑﺎ 20% ﺳﻮﻛﺮوز ﻗﺮار داده ﺷﺪند. ﺳﭙﺲ ﺑﻪ ﻫﺮ ﻛﺪام از ﭘﻠﻴﺖ ﻫﺎ 5 ﺳﻰ ﺳﻰ از ﺳﻮﺳﭙﺎﻧﺴﻴﻮن ﻣﻴﻜﺮوﺑﻰ ﺗﻬﻴﻪ ﺷﺪه اﺿﺎﻓﻪ ﺷﺪ. ﭘﻠﻴﺖ ﻫﺎ ﺑﻪ ﻣﺪت 5 روز در اﻧﻜﻮﺑﺎﺗﻮر 37 درﺟﻪ ﺳﺎﻧﺘﻰ ﮔﺮاد اﻧﻜﻮﺑﻪ ﺷﺪﻧﺪ. ﺳﭙﺲ ﺑﻌﺪ از ﺧﺎرج ﺳﺎزي ﻣﺤﻴﻂ ﻣﺎﻳﻊ ﻧﻮﺗﺮﻳﻨﺖ ﺑﺮاث از ﭘﻠﻴﺖ ﻫﺎ، ﭘﻠﻴﺖ ﻫﺎ ﺳﺮو ﺗﻪ ﺷﺪه و ﺗﻌﺪاد ﻛﻠﻮﻧﻰ ﻫﺎي ﭼﺴﺒﻴﺪه ﺑﻪ ﭘﻠﻴﺖ ﺑﻪ ﺻﻮرت ﭼﺸﻤﻰ ﺷﻤﺎرش ﺷﺪه و ﺑﺮ اﺳﺎس colony forming unit (CFU) ﺑﻴﺎن ﺷﺪﻧﺪ. در مرحله بعدي آزمايش به منظور تاييد مرحله اول مطالعه براكت ها درون محيط بلود آگار قرار گرفته و كلوني هاي حاصل مورد شمارش قرار گرفته كه نتايج حاصله از آن تاييد كننده مرحله اول بود. داده ﻫﺎ ﺗﻮﺳﻂ آزﻣﻮن آﻣﺎري ANOVA ﻣﻮرد ﻗﻀﺎوت ﻗﺮار گرفتند. يافته ها: ﺗﺤﻘﻴﻖ روي 60 ﻧﻤﻮﻧﻪ ﺑﺮاﻛﺖ از ﺳﻪ نوع ﻓﻠﺰي، ﺳﺮاﻣﻴﻜﻰ و self-ligating اﻧﺠﺎم ﺷﺪ. نتايج مطالعه نشان داد كه ﺑﻴﺸﺘﺮﻳﻦ ﻣﻴﺰان ﭼﺴﺒﻨﺪﮔﻰ اﺳﺘﺮﭘﺘﻮﻛﻮك ﻣﻮﺗﺎﻧﺲ به ترتيب ﻣﺘﻌﻠﻖ ﺑﻪ ﺑﺮاﻛﺖ self-ligating ﺑﻪ ﻣﻴﺰان 01/15± 25/51 و ﺑﻌﺪ ﺑﺮاﻛﺖ ﻓﻠﺰي ﺑﻪ ﻣﻴﺰان 1/7± 8/21 و ﺑﺮاﻛﺖ ﺳﺮاﻣﻴﻜﻰ ﺑﻪ ﻣﻴﺰان 6/3± 5/15ﺑﻮد و تفاوت بين 3 گروه معني دار بود (001/0(P<. در ضمن نتايج حاصله با آزمايش نمو.نه ها در محيط كشت بلود اگار نيز تاييد شد (p<0.01). ﻧﺘﻴﺠﻪ ﮔﻴﺮي: ﻣﻴﺰان رﺷﺪ و ﭼﺴﺒﻨﺪﮔﻰ اﺳﺘﺮﭘﺘﻮﻛﻮك ﻣﻮﺗﺎﻧﺲ در ﺣﻀﻮر ﺑﺮاﻛﺖ ﻫﺎي ارﺗﻮدﻧﺴﻰ ﺑﺎ ﺟﻨﺲ ﻫﺎ و ﻃﺮاﺣﻰ ﻫﺎي ﻣﺨﺘﻠﻒ، ﻣﺘﻔﺎوت اﺳﺖ. بيشترين چسپندگي اﺳﺘﺮﭘﺘﻮﻛﻮك ﻣﻮﺗﺎﻧﺲ متعلق به ﺑﺮاﻛﺖ self-ligating و كمترين ميزان چسپندگي متعلق به براكت سراميكي بود.

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 self-ligating) 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 self-ligating (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 self-ligating metallic brackets showed higher adhesion and growth of Streptococcus mutans than conventional twin metal brackets, followed by Ceramic brackets.