ANÁLISE DA FORMAÇÃO DE BIOFILME MULTIESPÉCIE EM ALINHADORES ORTODÔNTICOS FABRICADOS PELOS MÉTODOS FULL-SERVICE E IN-OFFICE
Resumo
Objetivo: Comparar a atividade metabólica de biofilme subgengival multiespécies, formado sobre alinhadores transparentes produzidos por empresas especializadas, no método full-service e placas termoformadas utilizadas para confecção de alinhadores em consultório, no método in-office, considerando a composição do material e o fluxo de fabricação. Métodos: Foram avaliados dez tipos de alinhadores termoformados: quatro advindos do método full-service de quatro diferentes empresas (Invisalign®, ClearCorrect®, NewAligner® e SouSmile®) e seis comumente produzidos para protocolos de tratamento em consultório (sistema in-office). Os alinhadores in-office foram termoformados sobre modelos impressos em 3D, produzidos por estereolitografia/visualização por cristal líquido (SLA/LCD) ou modelagem por deposição fundida (FDM). Dos alinhadores obtidos após termoplastificação, foram seccionados espécimes retangulares (5 × 8 × 0,75 mm) da superfície vestibular da região do incisivo central superior (n = 8 por grupo) e expostos por 7 dias a um biofilme subgengival complexo, multiespécies. A atividade metabólica do biofilme foi quantificada por redução de cloreto de 2,3,5-trifeniltetrazólio (TTC) e análise espectrofotométrica. Os dados foram analisados por ANOVA one-way, seguida pelo teste post hoc de Tukey. O nível de significância adotado foi de 5%. Resultados: Os resultados mostraram diferenças estatisticamente significativas inter e intra-grupos. Entretanto, não foram observadas diferenças estatisticamente significativas entre os métodos de impressão 3D utilizados durante a confecção dos alinhadores in-office.
Referências
1. Jeremias HG, Bister D, Newton JT. Social perceptions of adults wearing orthodontic appliances: a cross-sectional study. Eur J Orthod. 2011;33(5):476-482. DOI: https://doi.org/10.1093/ejo/cjq069
2. Sfondrini MF et al. Buccolingual inclination control of upper central incisors of aligners: a comparison with conventional and self-ligating brackets. Biomed Res Int. 2018; 2018:9341821. DOI: https://doi.org/10.1155/2018/9341821
3. Jiang Q, Li J, Mei L, Du J, Levrini L, Abbate GM, et al. Periodontal health during orthodontic treatment with clear aligners and fixed appliances: A meta-analysis. J Am Dent Assoc. 2018;149(8):712-720.e12. DOI: https://doi.org/10.1016/j.adaj.2018.04.010
4. Phan X, Ling PH. Clinical limitations of Invisalign®. J Can Dent Assoc. 2007;73(3):263-6.
5. Ren Y, et al. Orthodontic treatment with fixed appliances and biofilm formation—a potential public health threat? Clin Oral Investig. 2014;18:1711-1718. DOI: https://doi.org/10.1007/s00784-014-1240-3
6. Socransky SS, Haffajee AD. Dental biofilms: difficult therapeutic targets. Periodontol 2000. 2002;28:2-55. DOI: https://doi.org/10.1034/j.1600-0757.2002.280102.x
7. Socransky SS, Haffajee AD. Periodontal microbial ecology. Periodontol 2000. 2005;38:135-87. DOI: https://doi.org/10.1111/j.1600-0757.2005.00107.x
8. Ireland AJ, et al. The effects of different orthodontic appliances upon microbial communities. Orthod Craniofac Res. 2014;17(2):115-123.
9. Liu M, Wang Y, Bian C, Han Y, Qin X, Sun J, Bai Y, Zhang N. Comparative mechanical performance of thermoplastic materials for clear aligners under simulated oral conditions. Korean J Orthod. 2025 Sep 25;55(5):380-391. DOI: https://doi.org/10.4041/kjod25.094
10. Karkhanechi M et al. Periodontal status of adult patients treated with fixed buccal appliances and removable aligners over one year of active orthodontic therapy. Angle Orthod. 2013;83(1):146-51. DOI: https://doi.org/10.2319/031212-217.1
11. Schupp W, Haubrich J, Neumann I. Class II correction with the Invisalign® system. J Clin Orthod. 2010;44(1):28-35.
12. Bichu YM, et al. Advances in orthodontic clear aligner materials. Bioact Mater. 2023;22:384-403. DOI: https://doi.org/10.1016/j.bioactmat.2022.10.006
13. Dhingra K, et al. A comprehensive review of the methodologies used in in-office and full-service aligner fabrication. Orthod Craniofac Res. 2022;25(3):243-259.
14. Djeu G, Shelton C, Maganzini A. Outcome assessment of Invisalign® and traditional orthodontic treatment compared with the American Board of Orthodontics objective grading system. Am J Orthod Dentofacial Orthop. 2005;128(3):292-298. DOI: https://doi.org/10.1016/j.ajodo.2005.06.002
15. Lagravere MO, Flores-Mir C. The treatment effects of Invisalign® orthodontic aligners: a systematic review. J Am Dent Assoc. 2005;136(12):1724-1729. DOI: https://doi.org/10.14219/jada.archive.2005.0117
16. Yeh CC. Trend analysis for the market and application development of 3D printing. Int J Autom Smart Technol. 2014;4(1):1-3. DOI: https://doi.org/10.5875/ausmt.v4i1.597
17. Spoerk M, Savandaiah C, Arbeiter F, Sapkota J, Holzer C. Optimization of mechanical properties of glass‐spheres‐filled polypropylene composites for extrusion‐based additive manufacturing. Polym Compos. 2019;40:638. DOI: https://doi.org/10.1002/pc.24701
18. Dizon JRC, Espera AH, Chen Q, Advincula RC. Mechanical characterization of 3D-printed polymers. Addit Manuf. 2018;20:44–67. DOI: https://doi.org/10.1016/j.addma.2017.12.002
19. Porojan L, Bejan FR, Tirziu E, Gașpar CM, Moza AC, Gherban MI, Vasiliu RD, Matichescu A. Microbiological Evaluation of Thermoplastic PETG Dental Appliances Related to Surface Characteristics. Polymers. 2024; 16(16):2354. DOI: https://doi.org/10.3390/polym16162354
20. Moreno A, Santos DM dos, Melo Neto CL de, Moreno AL de M, Bertoz AP de M, Goiato MC. In vitro evaluation of the effect of different disinfectants on the biofilm of Staphylococcus epidermidis and Staphylococcus aureus formed on acrylic ocular prostheses. PLoS One. 2020 Oct 12;15(10):e0240116. DOI: https://doi.org/10.1371/journal.pone.0240116
21. Miranda SLF, Damaceno JT, Faveri M, et al. In Vitro Antimicrobial Effect of Cetylpyridinium Chloride on Complex Multispecies Subgingival Biofilm. Braz Dent J. 2020;31(2):103-108. DOI: https://doi.org/10.1590/0103-6440202002630
22. Pingueiro J, Piattelli A, Paiva J, Figueiredo LC, Feres M, Shibli J, Bueno-Silva B. Additive manufacturing of titanium alloy could modify the pathogenic microbial profile: an in vitro study. Braz Oral Res. 2019 Sep 30;33(suppl 1):e065. DOI: https://doi.org/10.1590/1807-3107bor-2019.vol33.0065
23. Sánchez MC, Alonso-Español A, Ribeiro-Vidal H, Alonso B, Herrera D, Sanz M. Relevance of Biofilm Models in Periodontal Research: From Static to Dynamic Systems. Microorganisms. 2021; 9(2):428. DOI: https://doi.org/10.3390/microorganisms9020428
24. Eliades T, Eliades G, Brantley WA. Microbial attachment on orthodontic appliances: I. Wettability and early pellicle formation on bracket materials. Am J Orthod Dentofacial Orthop. 1995;108(4):351-360. DOI: https://doi.org/10.1016/S0889-5406(95)70032-3
25. Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25(2):134-44. DOI: https://doi.org/10.1111/j.1600-051X.1998.tb02419.x
26. Low B, Lee W, Seneviratne CJ, Samaranayake LP, Hägg U. Ultrastructure and morphology of biofilms on thermoplastic orthodontic appliances in ‘fast’ and ‘slow’ plaque formers. Eur J Orthod. 2011;33:577–583. DOI: https://doi.org/10.1093/ejo/cjq126
27. Ireland AJ et al. The effects of different orthodontic appliances upon microbial communities. Orthod Craniofac Res. 2014 May;17(2):115-23. DOI: https://doi.org/10.1111/ocr.12037
28. Zhang M. et al. Biological safe gold nanoparticle-modified dental aligner prevents the porphyromonas gingivalis biofilm formation. ACS Omega. 2020;5(30):18685–18692. DOI: https://doi.org/10.1021/acsomega.0c01532
29. Worreth S, et al. Cinnamaldehyde as antimicrobial in cellulose‐based dental appliances. J Appl Microbiol. 2022;132(2):1018-1024. DOI: https://doi.org/10.1111/jam.15283
