HALITOSIS WITH FIXED ORTHODONTIC APPLIANCE VS REMOVABLE ORTHODONTIC ALIGNERS: A PILOT STUDY
Figure 4. Example of chart showing the levels of the three VSC
3. Results The values measured by the gascromatograph show a significant difference between the two groups. The minimum value for each gas in both groups is 0, while the maximum values are:- AG group: 76( H2S), 17( CH3SH) and 3(( CH3) 2S). They are all under the threshold.- FG group: 491( H2S), 45( CH3SH) and 44
Table 1. Mean for each gas |
|
AG |
|
|
FG |
|
|
H 2
S
|
CH 3
SH
|
( CH 3
) 2
S
|
H 2
S
|
CH 3
SH
|
( CH 3
) 2
S
|
11,2 1,7 0,3 123,7 7 7,7
(( CH3) 2S). In this case all the values are over the threshold. We also considered the mean of both groups. Means confirm the difference between AG and FG group( FG mean > AG mean) in all three values( Tab. 1). The standard deviation study shows that AG values are nearer to average than FG values( Tab. 2).
Table 2. Standard deviation for each gas |
|
AG |
|
|
FG |
|
|
H 2
S
|
CH 3
SH
|
( CH 3
) 2
S
|
H 2
S
|
CH 3
SH
|
( CH 3
) 2
S
|
24,0 5,4 0,9 179,2 14,5 14,2
4. Discussion This study evaluates the presence of volatile sulfur compounds( VSCs) in patients with orthodontic aligners compared to patients with orthodontic fixed appliances. In the aligner group, the three gases evaluated by OralChroma were below the threshold in the 10 patients participating in this study. Instead, in the fixed orthodontics appliance group, there were considerable differences between the patients. Five subjects in this group were over the threshold for at least one gas value and this is sufficient to consider these individuals as halitosis carriers, but two of this group were over the threshold for two gas values. The other five subjects, instead, were under the threshold for all of the three gas values measured in this study. The literature is poor on studies that compare the presence of halitosis between two types of orthodontic appliances, but they treat separately the halitosis problem and the two appliances considered in this study. The Rosenberg’ s study 2 shows that approximately 50 % of the middle-aged and older individuals emit socially unacceptable breath. Zurfluh et al., instead, studied halitosis in the presence of fixed orthodontic appliances and in this case the percentage increases. One of the causes must be sought in the decrease of dental hygiene performance that leads to an increase of the plaque and tongue coating indexes. Lara- Carillo et al. demonstrated that brackets and ligatures have a negative effect on natural cleaning because they create retention areas for plaque and increase the viscosity of the saliva. For the same reason they make the mechanical cleaning of the teeth and the gingiva, performed by tongue and lips, also more difficult. Furthermore, for Pellegrini et al. an increase of plaque index causes an increase in the bacterial count, which clearly is involved in the formation of halitosis 9. Starting from these considerations, many studies have been conducted by several authors 6, 7, 13 about selfligating brackets( SLB), because the absence of ligatures was supposed to provide fewer retention areas than in other bracket ligation types, but the opening / closing mechanisms may provide, on the contrary, additional plaque retention
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