Plaque accumulation and Streptococcus mutans levels around self-ligating bracket clips and elastomeric modules: A randomized controlled trial

Aim: To determine the effect of two different ligating systems that is, elastomeric modules and self-ligating (SL) bracket systems (Smartclip - 3M Unitek) with respect to harboring bacterial plaque in fixed orthodontic treatment. Objectives: To assess, evaluate, and compare the amount of plaque accumulation and Streptococcus mutans colonization around elastomeric ligation and SL clips in the smart clip appliance. Materials and Methods: A total of 111 orthodontic patients scheduled for fixed orthodontic treatments were selected for this split maxillary arch study. All the patients were bonded with smart-clip (3M Unitek) SL brackets, and the wire was placed into the bracket slots, on the randomly selected hemi arch, elastomeric modules were placed for the study to be conducted. Microbial and periodontal plaque accumulation was recorded at 3-time intervals post ligation. Plaque index-by Silness and Loe, modified Quigely Hein index, bleeding on probing were evaluated, and biofilm was collected from the tooth surface after 30 days and placed in petri dishes containing Mitis Salivarius agar for bacterial culturing. Result: It was observed that the side where ligation was done with elastomeric modules accumulated more plaque and increase in S. mutans colony forming units as compared to the side without external ligation (P < 0.05). Conclusion: Reduced bacterial colonization and better plaque control was seen with SL orthodontic bracket appliance system as compared to conventional ligation method