Quantitative in-vitro Analysis of Streptococcus mutans Adherence to Orthodontic Materials Treated with Cetylpyridinium Chloride Mouthwash

Abstract

Background: Orthodontic materials have a high cariogenic potential, and carious lesions often develop during orthodontic treatment due to the pervasive growth of bacterial flora. Streptococcus mutans is the main etiologic agent in the formation of dental caries.

Objectives: This study investigated the effect of Cetylpyridinium chloride (CPC) mouth rinse on S. mutans adherence to orthodontic brackets and adhesives.

Methodology: Twenty (20) each of saliva-coated orthodontic bracket types [metal, ceramic, and self-ligating] as well as adhesive specimens [Self-Cure adhesive (System 1+); Light-Cure adhesive (Transbond XT); and Resin Modified Glass Ionomer (Fuji Ortho LC)] were exposed to S. mutans and then rinsed with distilled water. Half of the specimens were further immersed in CPC for 30 seconds. All samples were immersed in Dey-Engley broth and subjected to a Maki method of culture. CFUs were determined for each group.

Results: There was no significant difference in S. mutans CFUs among the three different kinds of brackets when rinsed with either water or with CPC. However, there was a significant overall reduction of CFUs when brackets were subjected to CPC as compared to water alone. Among adhesives in water, System +1 yielded significantly lower colonies of S. mutans than the other adhesive types. On intervention with the CPC, the type of adhesive material does not affect the effectiveness of the mouthwash. Further treatment of the CPC mouthwash produced significantly lower CFU counts in brackets and adhesives than those rinsed with sterile distilled water.

Conclusion: Prophylactic use of a CPC mouthwash as an adjunct to plaque control is recommended for orthodontic patients.

Key words: S. mutans adherence, orthodontic brackets, orthodontic adhesives, cetylpyridinium chloride (CPC) mouthwash