Features of the oral microbiome at different stages of orthodontic treatment of children and adolescents

Abstract

Introduction. The article presents the analysis of the results of the study of the spectrum, frequency and number of microorganisms in the oral fluid before the beginning of orthodontic treatment of dento-jaw anomalies and deformations and at its stages (6 and 12 months). As a result of the study, the emergence of the pathogenic microorganism Staphylococcus aureus and a large number of opportunistic fungi of the genus Candida and Porphyromonas spp. The obtained results indicate the need to develop standards for the management of orthodontic patients. The purpose of the study: assessment of the qualitative and quantitative composition of microorganisms in patients with dento-jaw anomalies and deformations before the installation of fixed orthodontic equipment, 6 and 12 months after the start of treatment for proper prevention and development of methodological approaches. Materials and methods. 62 children aged 12-15 with fixed orthodontic appliances were examined. The age unification of the contingent of patients is due to the fact that during the period of permanent bite in children, the periodontal tissues have a mature differentiated morphological structure and the changes determined in them cannot be related to their formation and periods of growth. These patients had healthy periodontal tissues before the placement of orthodontic equipment. 2 groups were formed from the examined patients: Group I – 32 children, patients with chronic catarrhal gingivitis that occurred during orthodontic treatment. Among them, according to gender, 17 are girls and 15 are boys; II group – control – 30 practically healthy children of the same age (15 girls and 15 boys). The material of the microbiological study was the washings of the oral cavity. Determination of the species composition of the oral microbiome was carried out at the beginning of orthodontic treatment – 3 months, and at control points – 6 months and 12 months after fixation of the bracket system. Patients with chronic catarrhal gingivitis were not treated during the entire study period. During the examination period, the patients did not take antibiotics, nonsteroidal anti-inflammatory drugs, or hormonal drugs. Oral fluid was collected in a sterile test tube in the amount of 1-2 ml. 2 hours before the collection of the material, the patients did not eat, did not brush their teeth, and did not treat the oral cavity with antiseptic agents. The material was delivered to the laboratory of the Research and Educational Center for Molecular Microbiology and Immunology of Mucous Membranes of the Uzhgorod National University of Higher Secondary School within 1 hour. The results. The study of the microbial composition of oral cavity washes of patients with clinical signs of inflammatory periodontal tissue diseases against the background of using a brace system allowed us to establish characteristic qualitative and quantitative changes in the oral microbiome. Before the orthodontic treatment, that is, before the placement of the brace system, no signs of periodontal tissue inflammation were observed in these patients. At the beginning of orthodontic treatment in children with clinical manifestations of inflammatory diseases of periodontal tissues, Streptococcus spp. microorganisms were isolated in 32 patients, Peptostreptococcus spp. in 26 patients, Enterobacteriaceae in 10 people, and Candida fungi were identified in 15 children. At the second stage of orthodontic treatment, bacteria of the genera Streptococcus and Peptostreptococcus were isolated in 32 patients. Frequency of bacteria Lactobacillus spp. increased by 15% and was isolated in 16 people, and bacteria of the Enterobacteriaceae family decreased by 19%, fungi of the genus Candida were determined in 19 people compared to the first stage. At the third stage of orthodontic treatment, indicators of microorganisms isolated from oral fluid washes, in particular Streptococcus spp. and Peptostreptococcus spp. has not changed. The frequency of detection of Enterobacteriaceae bacteria (34.2%) increased by 20%, and Candida fungi decreased from 49.3 to 32.3%, the frequency of identification of Lactobacillus spp. was 52.5%. The results of microbiological research in children at different stages of orthodontic treatment showed an increase in the number of bacteria, which under favorable conditions can threaten not only inflammation of periodontal tissues, but also their further destruction. Conclusions. According to examination data, the genera Streptococcus, Peptostreptococcus, Lactobacillus, Bifidobacterium, Enterococcus, and Staphylococcus are dominant in the oral cavity. In children with fixed orthodontic appliances, microorganisms that are not characteristic of the normal microbiome of the oral cavity were identified in the oral fluid, an increase in periodontal pathogenic microorganisms belonging to the genera Veillonella Neisseria, Actinobacillus, fungi of the genus Candida and the family Enterobacteriaceae, which under favorable conditions can cause and increase the inflammatory process in periodontal tissues.