Evaluation of Biofilm Adhesion and Microbiological Colonization on Orthodontic Archwires: A Randomized Clinical Trial

Abstract

Fixed orthodontic appliances promote biofilm accumulation and increase the risk of oral diseases. This randomized clinical trial evaluated the influence of orthodontic archwire manufacturer and material on early biofilm adhesion and microbial colonization during fixed orthodontic treatment. Four manufacturer groups — American Orthodontics, MATT, GC Orthodontics, and Aditek — were randomly assigned to forty patients. Archwires made of nickel-titanium (NiTi) and stainless steel (SS) were placed intraorally for a month in each group. Biofilm formation was measured by crystal violet staining and expressed as optical density (OD), And microbial colonization was gauge by colony-forming unit (CFU) counts of Streptococcus mutans, Staphylococcus aureus, and Candida albicans. One-way ANOVA, Tukey's post hoc test, and independent-samples t-tests (p < 0.05) were used to examine the data. While Staphylococcus aureus and Candida albicans were found in just 20% of samples, Streptococcus mutans was the most common bacterium, found in 72.5% of samples. There were notable variations in S. mutans adherence between the four manufacturers (p = 0.020).MATT had the most bacterial colonization, Aditek the lowest, and American Orthodontics and GC Orthodontics the intermediate adhesion levels. The only significant difference found by Tukey's post hoc analysis was between Aditek and MATT (p = 0.015). Initial microbial adhesion (CFU) did not significantly differ between SS and NiTi archwires. NiTi archwires, on the other hand, tended to show higher optical density values, which suggested more biofilm maturation. There were no discernible variations in the prevalence of S. aureus and Candida albicans between manufacturers or materials. When combined, these results suggest that early bacterial adhesion to orthodontic archwires is more influenced by manufacturing features than by alloy type. While the initial microbial colonization of SS and NiTi archwires was similar, NiTi tended to promote the production of denser biofilms. The biological performance of orthodontic archwires should therefore be considered alongside their mechanical properties when selecting materials for clinical orthodontic treatment.