Effect of bracket type on halitosis, periodontal status, and microbial colonization

Angle Orthod. 2014 May;84(3):479-85. doi: 10.2319/061913-461.1. Epub 2013 Nov 4.


Objective: To determine the effect of bracket type on halitosis, periodontal status, and microbial colonization.

Materials and methods: Forty-six patients scheduled for fixed orthodontic treatment (age 11-16 years) were selected from the orthodontic department of Suleyman Demirel University. Patients were divided into two groups with random distribution of brackets; 23 patients were treated with self-ligating brackets (group SLBs), the others with conventional brackets (group CBs). Halitosis measurements and periodontal and microbial records were obtained before the placement of brackets (T0), 1 week later (T1), and 5 weeks after bonding (T2). Periodontal parameters, including plaque index (PI), gingival index (GI), and bleeding on probing index (BOP), were obtained from all the bonded teeth. Halitosis measurements were performed at the same time. Microbial samples were obtained from the buccal surfaces of all the bonded teeth. Data were analyzed by using a repeated-measurement analysis of variance test for the comparison of parameters between groups and times.

Results: Periodontal parameters and halitosis results were higher in the CBs group than in the SLBs group (P<.05). In the SLBs group, halitosis and BOP values revealed no pronounced changes between T1 and T2 (P>.05). Intra- and intergroup comparisons showed that there were no statistically significant differences for microbial colonization between all the time intervals (P>.05).

Conclusion: Bracket type has an effect on halitosis and periodontal status. Therefore, self-ligating brackets may be advised in order to prevent patients from developing halitosis and to increase the likelihood of good oral hygiene during orthodontic treatment.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Bacterial Load
  • Child
  • Dental Plaque Index
  • Female
  • Follow-Up Studies
  • Gingival Hemorrhage / classification
  • Gingivitis / classification
  • Halitosis / classification*
  • Halitosis / microbiology
  • Humans
  • Lactobacillus / isolation & purification
  • Male
  • Oral Hygiene
  • Orthodontic Appliance Design*
  • Orthodontic Brackets / classification*
  • Orthodontic Brackets / microbiology
  • Periodontal Index*
  • Prospective Studies
  • Streptococcus mutans / isolation & purification
  • Surface Properties
  • Tooth / microbiology*