Periodontal and microbiologic evaluation of 2 methods of archwire ligation: Ligature wires and elastomeric rings

Introduction: Prophylactic programs to prevent dental biofilm accumulation must be implemented to minimize the risk for periodontal diseases in orthodontic patients. Therefore, we assessed the possible periodontal and microbiologic changes resulting from the use of 2 methods of orthodontic archwire ligation: elastomeric rings and steel ligatures. Methods: The following parameters were measured: plaque index, gingival bleeding index, probing depth, and biofilm samples from the maxillary second premolars and the mandibular lateral incisors were evaluated in 14 subjects without clinical signs of gingival inflammation before orthodontic appliance placement and after 6 months of treatment. Each orthodontic arch was fixed with elastomeric rings on 1 side of the midline, and steel ligatures were used on the opposite side. Polymerase chain reaction analysis was used to detect Porphyromonas gingivalis, Tannerella forsythia, Actinobacillus actinomycetemcomitans, Prevotella intermedia, and P nigrescens. Results: The elastomeric rings were associated with a higher score for plaque index and bleeding than steel ligatures, as well as many positive sites of T forsythia and P nigrescens (P <0.05). Conclusions: Elastomeric rings favored these 2 periodontopathogens and harmed gingival conditions.