The effects of orthodontic appliances on Candida in the human mouth.

BACKGROUND: Candida is an opportunistic pathogen present in about 50-60% of the healthy human population, and becomes pathogenic when the host immune defence is undermined such as in HIV infection. Adhesion and colonization of the oral cavity by Candida albicans is an initial step in candidosis, and the presence of orthodontic and other oral appliances seems to alter the oral ecological environment, hence may tip the balance to favour the candidal presence. OBJECTIVE: The purpose of this paper was to review the literature with specific attention to prevalence; intra-oral density of the candidal organisms; and Candida carriage status in orthodontic patients before, during, and after treatment. CONCLUSIONS: The limited amount of literature demonstrated that the density of Candida increases; the most common Candida species isolated in the orthodontic patients was C. albicans; and that there seems to be a direct relationship between the presence of a removable appliance, Candida, and low salivary pH levels. No healthy patients developed Candida infection from the orthodontic appliances. However, there seems to be a trend that some non-Candida carriers converted to Candida carriers following the insertion of the appliances by unknown mechanism. This may indicate a more cautious approach when providing orthodontic treatments to immunocompromised children concerning the possible increased risk of candidal infection.

The Hybrid Orthodontic Treatment System (HOTS).

This paper describes the Hybrid Orthodontic Treatment System (HOTS), an innovative method used in first premolar extraction cases. It comprises the following three components: (1) a miniscrew, (2) dual-dimension wires, and (3) multiloop edgewise archwires. HOTS consists of four clearly defined treatment steps: (1) setup, (2) leveling, (3) separate but simultaneous anterior and canine teeth retraction, and (4) final adjustment. HOTS achieves a predictable treatment outcome with a shorter treatment time.

Orthodontic tooth movement enhancing bony apposition in alveolar bony defect: a case report.

INTRODUCTION: Prevalence of complications from orthognathic surgery is relatively low but if it happens it is vital to manage the post complication bony defect appropriately. CASE PRESENTATION: This case report describes a 20-year-old gentleman who suffered from a complication from a bimaxillary orthognathic surgery. A bone grafting was carried out to repair the bony defect from the surgery but it was unsuccessful. A non-invasive technique employing the use of very light orthodontic force with a laceback stainless steel ligature is described and a successful space closure with an improvement in the periodontal condition and bone apposition has been shown. CONCLUSION: This technique can be considered if orthodontic tooth movement is needed across a deficient alveolar ridge.

The role of salivary factors in persistent oral carriage of Candida in humans.

BACKGROUND: Candida albicans is a commensal oral yeast in approximately one-third to one-half of the healthy population. To date, there are no studies investigating the multiple anti-candidal salivary constituents of healthy individuals with either nil or, consistent oral yeast carriage. OBJECTIVE: To compare the composition and anti-candidal activity in stimulated whole saliva of healthy 'consistent' oral Candida carriers with Candida-free individuals. METHODS: A sub-sample of 22 consistent, Candida-free individuals and 10 consistent Candida carriers were recruited from a 12 months screening study investigating oral Candida carriage in 97 healthy patients treated by fixed orthodontic appliances. Unstimulated and stimulated saliva samples were collected. The following salivary attributes were measured using standard methodology: the flow rate, pH, lysozyme, lactoferrin and IgA concentration and, the degree of inhibition of blastoconidial growth and blastospore germination. RESULTS: Saliva from the Candida-free individuals showed 20.2% higher inhibition of blastoconidial growth (p < 0.05) of a reference strain of Candida albicans. No significant differences between the other salivary attributes of the two groups were found. CONCLUSION: The fact that saliva of Candida-free individuals significantly inhibited the blastoconidial growth more than Candida-carriers (p < 0.05) suggests that saliva may play a role in modulating oral candidal populations in health. Further studies, with a larger cohort are needed to confirm these findings and determine the factors that confer enhanced salivary anti-candidal activity.