Download 7.3 Does the study require any investigations to be conducted on

Rajiv Gandhi University of Health Sciences, Bangalore
Karnataka
M.D.S Orthodontics and Dentofacial Orthopedics
Synopsis for Registration of Dissertation
MARATHA MANDAL’S
NATHAJIRAO G. HALGEKAR INSTITUTE
OF DENTAL SCIENCES & RESEARCH CENTRE
BAUXITE ROAD, BELGAUM
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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
ANNEXURE II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
DR. KINJAL J MAVANI
DEPARTMENT
Name
of
Candidate
OF
ORTHODONTICS
AND
DENTOFACIAL
and
ORTHOPAEDICS,
1
address
MMNGH INSTITUTE OF DENTAL SCIENCES AND RESEARCH
CENTRE,NEAR K.S.R.P. GROUND
R.S NO. 47A/2,BAUXITE ROAD,BELGAUM – 590010
MARATHA
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MANDAL’S
NATHAJIRAO
G.
HALGEKAR
Name of the institution
INSTITUTE OF DENTAL SCIENCES & RESEARCH CENTRE,
BELGAUM
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Course of study and
MDS
subject
ORTHODONTICS AND DENTOFACIAL ORTHOPAEDICS
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Date of admission to course
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Title of the Topic
30-07-2012
MICROBIAL COLONISATION ON ELASTOMERIC MODULES
DURING ORTHODONTIC TREATMENT - AN IN VIVO STUDY.
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Brief resume of intended work :
6.1 Need for study:
The placement of a fixed appliance often impedes the maintenance of good oral hygiene for
orthodontic patient.1 The components of the appliance create new retention areas for
microorganisms and impede proper access to tooth surfaces for optimal cleaning.1 Plaque retention
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surrounding orthodontic appliances leads to enamel demineralization caused by organic acids
produced by bacteria in the dental plaque2.
Numbers of studies have evaluated the effect of fixed orthodontic treatment on microbial flora but
only a few studies have evaluated microbial colonization on the elastomeric modules during
orthodontic treatment.
Therefore, this studywill help us to determine the microbial growth on elastomeric modules at
different time intervals during orthodontic treatment.
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6.2 Review of literature :
1. Carl Magnus Fornsberg, Vivecca Brattstorm, Eva Malmberg, and Carl Erik
Nord(1991)
Aim: To evaluate two methods of ligation and their association with microbial colonization of
Streptococcus mutans and lactobacilli.
Method: Twelve orthodontic patients undergoing orthodontic treatment with fixed appliances were
present in the study. In all patients elastomeric rings were used for ligation on one side of the dental
arch midline, whereas steel wires were used on the opposite side.
The number of microorganisms in samples of plaque, taken from the labial surface of the upper
lateral incisors, was recorded in five occasions during treatment. In samples of saliva, the numbers
of Streptococcus mutans and lactobacilli were recorded on the same occasions. This registration
was also made on two occasions before insertion of the fixed appliance and 6 weeks after the
period of active treatment.
Conclusion:In majority of patients, the incisor which was attached to the arch wire with an
elastomeric ring, exhibited a greater number of microorganisms in the plaque than the incisor
ligated with steel wire.
Following insertion of fixed appliances the number of S.mutans and lactobacilli in saliva increased
significantly. Variations in the number of microorganisms in the saliva during active treatment
were not reflected in any relative increase or decrease in microbial colonization on either steel
ligatures or elastomeric rings.
The use of retainers after active treatment was not associated with increased numbers of
microorganisms in the saliva.
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2.
Hakan Turkkahraman, M.Ozgur Sayin, F.Yesim Bozkurt, Zuhal Yetkin,
Selcuk Kaya, Suleyman Onal.(2005)
Aim: To determine the changes in the microbial flora and periodontal status after orthodontic
bonding and to determine whether two arch wire ligation techniques affect these changes.
Method: A total of 21 orthodontic patients scheduled for fixed orthodontic treatment were selected
for this split-mouth study. Two commonly used auxiliaries (elastomeric rings and ligature wires)
for tying arch wires were tested. Microbial and periodontal records were obtained before bonding
(T0), one week later (T1), and five weeks after bonding (T2). Paired t-test and Wilcoxon signed
rank test were used to compare the groups statistically. Although, teeth ligated with elastomeric
rings exhibited slightly greater numbers of microorganisms than teeth ligated with steel ligature
wires, the differences were not statistically significant and could be ignored.
Conclusion:Fixed orthodontic appliances significantly increase the colonization of S. mutansand
lactobacilli.
Plaque volume and gingivitis also increase with treatment, whereas bleeding and PDs remain the
same for the first five weeks of treatment.
Although teeth ligated with elastomeric rings exhibited a slightly greater number of
microorganisms than teeth ligated with steel ligature wires, the differences were not statistically
significant and could be ignored.
No significant effect of arch wire ligation technique was determined in the GI, BBPI, and PDs of
bonded teeth.
However, the teeth ligated with elastomeric rings were more prone to bleeding. Therefore, the use
of elastomeric rings is not recommended in patients with poor oral hygiene.
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3. Giovana Rembowski Casaccia; Janaına C. Gomes; Daniela Sales Alviano;
Antonio Carlos de Oliveira Ruellas; Eduardo FranzottiSant’ Anna. ( 2007)
Aim: To evaluate in vitro the surface of elastomeric chains of different manufacturers to verify the
presence of pathogenic microorganisms at the moment of unpacking and analyse a possible
inhibitory effect of the elastomeric chain when exposed to microorganisms of the oral cavity, for
example, Streptococcus mutans, Lactobacillus casei, and Candida albicans.
Methods: Elastomeric chains from Ortho-Organizers Inc, 3M Unitek, and DentalMorelli were
placed in petri plates with brain heart infusion agar medium and in sterile test tubes with brain heart
infusion broth. The samples were incubated at 37_C and analysed at 24 hours, 48 hours, 3 days,
and 7 days. In addition, elastomeric chains from the three manufacturers were placed in dishes,
inoculated with microorganisms, incubated at 37_C, and analysed after 24 and
72 hours.
Conclusion: No microorganism growth was detected after all incubation periods. No inhibition
zones were identified surrounding the elastomeric chain.
The results suggest that the fabrication of elastomeric chain is in accordance with biohazard
concepts. However, careful manipulation is necessary to avoid colonization of pathogenic
microorganisms since the composition of the elastomeric chains analysed do not include
antimicrobial agents.
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6.3 Objective of the study:
1. To evaluate microbial colonization of Streptococcus mutans and Lactobacilli on elastomeric
modules during orthodontic treatment.
2. Additionally, to determine the extent of this microbial colonization at different time
intervals.
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Methodology
7.1 Source of data:
Patients undergoing orthodontic treatment in the Department of Orthodontics and Dentofacial
Orthopaedics of Maratha Mandal’s NGH Institute of Dental Sciences and Research Centre,
Belgaum.
7.2 Methods of collection of data :
Sample size: 30 orthodontic patients
The sample for this study will consist of orthodontic patients in whom plaque accumulated on
elastomeric modules (3MUnitek)is evaluated at different time intervals.
Standard oral hygiene instructions will be given.
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Informed consent will be obtained from the patients.
Sample collected will be grouped as under :
Group 1-pre treatment
Group 2-at 1st week
Group 3- at 5th weeks
Group 4-at 8th weeks
The plaque accumulated on the elastomeric module will be collected by the operator by scraping it
and will be carried in a transport medium and cultured in the Department of Microbiology at
Maratha Mandal’s NGH Institute of Dental Sciences and Research Centre to evaluate the presence
and extent of Streptococcus mutans and Lactobacilli.
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Inclusion criteria:
1. Patients in the age group of 12-25years.
2. Patients in permanent dentition.
Exclusion criteria :
1. Subjects who had used antibioticsduringand three month period prior the study.
2. Patients having history of smoking or history of any periodontal disease.
Statistical analysis:
The results obtained will be subjected to Wilcoxon Matched Pairs test.
7.3 Does the study require any investigations to be conducted on patients or
other human or animals?
Yes.
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Enclosed.
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References :
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1. Forsberg CM, Brattstrom V, Malmberg E, Nord CE. Ligature wires and elastomeric rings:
two methods of ligation, andtheir association with microbial colonization of Streptococcus
mutansand lactobacilli. Eur J Orthod. 1991;13:416–420.
2. Turkkahramam H, Sayin MO, Bozkurt FY, Yetkin Z, Kaya S, OnalS.Archwire ligation
techniques, microbial colonization,and periodontal status in orthodontically treated patients.
Angle Orthod. 2005;75:231–236.
3. Rosenbloom RG, Tinanoff N. Salivary Streptococcus mutans levels in patients , during , and
after orthodontic treatment. Am J Ortho Dentofacial Orthop.1991;100:35-37.
4. Fournier A, Payant L, Bouclin R. Adherence of Streptococcus mutans to orthodontic
brackets. Am J OrthodDentofacialOrthop 1998;114:414-7.
5. Ahn SJ, Kho HS, Kim KK, Nahm DS. Adhesion of oral streptococci to experimental bracket
pellicle from glandular saliva. Am J OrthodDentofacialOrthop 2003;124 :198-205.
6. M.I Brusca;O.Chara; L.SterinBorda; A.C Rosa Influence of Different Orthodontic Brackets
on Adherance of Microorganisms In Vitro. Angle Orthd 2007 ; 77 -2:331-336
7. GiovanaRembowskiCasaccia; Janaına C. Gomes; Daniela Sales Alviano; Antonio Carlos
de Oliveira Ruellas; Eduardo FranzottiSant’ Anna .Microbial evaluation of elastomeric
chains.AngleOrthod 2007; 77-5:890-893
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8. Sug-JoonAhn,Shin-Jae
Lee,Bum-Soon
Lim,
and
Dong-SeokNahmQuantitative
determination of adhesion patterns of cariogenic streptococci to various orthodontic
brackets.Am J OrthodDentofacialOrthop December 2007
9. Jan van Gastel,MarcQuirynen,WimTeughels, Martin Pauwels,WimCoucke,CarineCarelsMicrobial Adhesion on Different Bracket Types in vitro. Angle Orthod 2009; 79-5:915-920
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9.
Signature of the candidate
Recommended
10.
Remarks of the Guide
11.1) Name and Designation
DR. VIJAY NAIK MDS
PROFESSOR AND HEAD,
ofthe Guide
DEPARTMENT OF ORTHODONTICS
MARATHA MANDAL’S
NATHAJIRAO G. HALGEKAR INSTITUTE OF DENTAL SCIENCES
& RESEARCH CENTRE, BELGAUM-590010
11.2) Signature
11.3) Co-Guide
(If any)
11.
11.4) Signature
DR.VIJAY R. NAIK M.D.S
PROFESSOR AND HEAD,
11.5) Head of the Department
DEPARTMENT OF ORTHODONTICS
MARATHA MANDAL’S
NATHAJIRAO G. HALGEKAR INSTITUTE OF DENTAL SCIENCES
& RESEARCH CENTRE, BELGAUM-590010
11.6) Signature
12.1)
Remarks
of
the
12.
Principal
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