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Publication
Alteração do microbioma oral pelo uso de alinhadores : estudo prospetivo in-vivo
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Abstract(s)
Objetivo: Investigar se o uso de alinhadores na terapia ortodôntica induz alterações no microbioma oral, que possam potenciar o desenvolvimento de patologia oral.
Materiais e métodos: A amostra foi constituída por pacientes que iniciaram tratamento ortodôntico exclusivamente com alinhadores, na Clínica Universitária Egas Moniz e numa clínica privada na região de Lisboa, entre dezembro de 2024 e abril de 2025. Realizaram-se colheitas em dois tempos distintos: na consulta inicial (t0) e na segunda consulta (t1), com intervalo médio de 1 mês e 3 dias. As colheitas foram realizadas em quatro locais específicos, abrangendo as superfícies vestibulares e os sulcos creviculares de incisivos laterais e de segundos pré-molares dos quadrantes superiores. A seleção dos quadrantes foi aleatória garantindo equidade de distribuição e manutenção do
mesmo lado nas colheitas em ambos os tempos. Foi efetuado isolamento nos meios de cultura Columbia agar 5% sague e Mitis Salivarius agar, para pesquisa e quantificação de microrganismos viáveis, com especial ênfase em microrganismos hemolíticos e Streptococcus orais. Realizou-se ainda extração e sequenciação do ADN para análise do
microbioma. A análise estatística dos dados obtidos foi efetuada com recurso ao programa SPSS através de técnicas de análise estatística descritiva e inferencial (testes t-student e Wilcoxon Signed Rank Test). Foi estabelecido um nível de significância de 5% (p<0.05).
Resultados: Verificou-se um aumento significativo na abundância relativa de microrganismos viáveis entre o tempo 0 e o tempo 1 (p<0.05), nomeadamente de espécies associadas à disbiose, como Streptococcus mutans e Enterococcus faecalis. A análise do microbioma evidenciou ainda alterações na abundância relativa entre filos e géneros,
destacando-se os géneros Streptococcus, Neisseria e Haemophilus. Em ambos os momentos, o Streptococcus foi o género mais abundante. No tempo t1, as contagens médias foram superiores às observadas no t0.
Conclusão: Os alinhadores ortodônticos influenciam no equilíbrio oral, promovendo
alterações microbiológicas que podem predispor ao desenvolvimento de condições patológicas.
Aim: To investigate if the use of aligners in orthodontic therapy induces changes in the oral microbiome that might promote the development of oral pathology. Materials and methods: The sample consisted of patients who have started orthodontic treatment exclusively with aligners, at the Clínica Universitária Egas Moniz and, in a private clinic in the Lisbon region, between December 2024 and April 2025. Samples were collected at two different times: at the beginning of the treatment (t0) and at the second procedure (t1), with an average time interval of 1 month and 3 days. Samples were collected from four specific locations, covering the vestibular surfaces and crevicular sulci of the lateral incisors and second premolars of the upper quadrants. The quadrants were selected randomly to ensure equitable distribution and maintenance of the same side in the samples at both times. Isolation was performed in Columbia agar 5% sague and Mitis Salivarius agar culture media for research and quantification of viable microorganisms, with special emphasis on hemolytic microorganisms and oral Streptococcus. DNA extraction and sequencing were also performed for microbiome analysis. Statistical analysis of the data obtained was performed using the SPSS program through descriptive and inferential statistical analysis techniques (t-student and Wilcoxon Signed Rank Test). A significance level of 5% (p<0.05) was established. Results: There is a significant increase in the relative abundance of viable microorganisms between time 0 and time 1 (p<0.05), particularly of species associated with dysbiosis, such as Streptococcus mutans and Enterococcus faecalis. Microbiome analysis also revealed changes in relative abundance between phyla and genera, particularly the genera Streptococcus, Neisseria, and Haemophilus. At both time points, Streptococcus was the most abundant genus. At t1, the mean counts were higher than those observed at t0. Conclusion: Orthodontic aligners have impact on the oral balance, by promoting microbiological changes wich lead to a higher risk to the development of pathological conditions.
Aim: To investigate if the use of aligners in orthodontic therapy induces changes in the oral microbiome that might promote the development of oral pathology. Materials and methods: The sample consisted of patients who have started orthodontic treatment exclusively with aligners, at the Clínica Universitária Egas Moniz and, in a private clinic in the Lisbon region, between December 2024 and April 2025. Samples were collected at two different times: at the beginning of the treatment (t0) and at the second procedure (t1), with an average time interval of 1 month and 3 days. Samples were collected from four specific locations, covering the vestibular surfaces and crevicular sulci of the lateral incisors and second premolars of the upper quadrants. The quadrants were selected randomly to ensure equitable distribution and maintenance of the same side in the samples at both times. Isolation was performed in Columbia agar 5% sague and Mitis Salivarius agar culture media for research and quantification of viable microorganisms, with special emphasis on hemolytic microorganisms and oral Streptococcus. DNA extraction and sequencing were also performed for microbiome analysis. Statistical analysis of the data obtained was performed using the SPSS program through descriptive and inferential statistical analysis techniques (t-student and Wilcoxon Signed Rank Test). A significance level of 5% (p<0.05) was established. Results: There is a significant increase in the relative abundance of viable microorganisms between time 0 and time 1 (p<0.05), particularly of species associated with dysbiosis, such as Streptococcus mutans and Enterococcus faecalis. Microbiome analysis also revealed changes in relative abundance between phyla and genera, particularly the genera Streptococcus, Neisseria, and Haemophilus. At both time points, Streptococcus was the most abundant genus. At t1, the mean counts were higher than those observed at t0. Conclusion: Orthodontic aligners have impact on the oral balance, by promoting microbiological changes wich lead to a higher risk to the development of pathological conditions.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Ortodontia Alinhadores Microbioma oral Patologia oral