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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