Evaluation of efficiency of chlorhexidine against microbial contamination on orthodontic brackets. An in vitro study

Abstract

Background

Orthodontic treatment with fixed appliances, including brackets, creates niches that favor microbial accumulation, leading to plaque formation and increased risk of enamel demineralization and gingival inflammation. Chlorhexidine is a well-established antimicrobial agent known for its efficacy in reducing bacterial load. This study aims to evaluate the efficiency of chlorhexidine in reducing microbial contamination on orthodontic brackets in vitro.

Materials and Methods

A total of 60 orthodontic brackets were divided into three groups of 20 each: Group A (control, no treatment), Group B (treated with 0.2% chlorhexidine solution), and Group C (treated with 0.12% chlorhexidine gel). The brackets were inoculated with Streptococcus mutans and incubated for 48 hours at 37°C to simulate oral conditions. After treatment, microbial contamination was assessed by culturing swab samples from the brackets on Mitis Salivarius Agar and quantifying the colony-forming units (CFUs). Data were analyzed using ANOVA with a significance level set at p < 0.05.

Results

Group A showed a mean CFU count of 10^6, indicating high microbial contamination. Group B demonstrated a significant reduction in CFU count (mean 10^3), and Group C showed the greatest reduction (mean 10^2). The differences between the groups were statistically significant (p < 0.01), confirming the antimicrobial efficacy of both forms of chlorhexidine, with the gel form being more

effective than the solution.

Conclusion

Chlorhexidine effectively reduces microbial contamination on orthodontic brackets, with 0.12% gel demonstrating superior antimicrobial activity compared to 0.2% solution. Regular application of chlorhexidine-based products may be a valuable adjunct in maintaining oral hygiene during orthodontic treatment.