The effect of fixed orthodontic treatment with Edgewise and Straightwire techniques on white spot lesions incidence and accumulation of Streptococcus mutans bacteria

Elfira Maharani, Dyah Karunia, Pinandi Sri Pudyani

Abstract views = 287 times | downloads = 126 times


Background: Fixed orthodontic appliances, such as Edgewise and Straightwire techniques, can increase the amount of plaque retention containing Streptococcus mutans (S. mutans), which can lead to white spot lesions. Purpose: The aim of this study is to analyse the correlation of fixed orthodontic treatment with Edgewise and Straightwire techniques on the incidence of white spot lesions and accumulation of S. mutans. Methods: The samples consisted of three groups: control group (n=8), Edgewise technique group, and Straightwire technique group. We observed the samples at the sixth month and eighth month of the treatment, after the installation of the fixed orthodontic appliances. The observation of white spot lesions with caries detector was applied in all regions. Bacterial swabs were acquired in the lateral incisor region, then a bacterial culture procedure was carried out on selective media of S. mutans, and then a bacterial count was performed. The data was analysed using two-way ANOVA, the post-hoc least square differences test, and the Pearson’s correlation test. Results: The number of white spot lesions in the Edgewise group was higher than in the Straightwire group in the sixth and eighth month of treatment with insignificant difference (p>0.05). The number of S. mutans bacteria increased in all groups, but there were no significant differences (p>0.05). There was no significant relationship between the number of white spot lesions with the accumulation of S. mutans between groups (p>0.05). Conclusion: The Edgewise and Straightwire techniques increase the incidence of white spot lesions but accumulation of S. mutans with the incidence of white spot lesions has no relationship.


Fixed orthodontic treatment; Edgewise technique; Straightwire technique; white spot lesions; S. mutans bacteria

Full Text:



Ribeiro GLU, Regis S, Da Cunha TDMA, Sabatoski MA, Guariza-Filho O, Tanaka OM. Multiloop edgewise archwire in the treatment of a patient with an anterior open bite and a long face. Am J Orthod Dentofac Orthop. 2010; 138(1): 89–95.

Cobourne MT, DiBiase AT. Handbook of orthodontics. London: Mosby Elsevier; 2010. p. 235–60.

Filho LC, Machado FM de C, Ozawa TO, Cavassan A de O, Cardoso M de A. Bracket/wire play: what to expect from tipping prescription on pre-adjusted appliancese. Dental Press J Orthod. 2012; 17(4): 85–95.

Spena R. Upper and lower incisor torque and straight-wire appliance. SIDO. 2014; : 21–32.

Mattousch TJH, van der Veen MH, Zentner A. Caries lesions after orthodontic treatment followed by quantitative light-induced fluorescence: A 2-year follow-up. Eur J Orthod. 2007; 29(3): 294–8.

Boersma JG, van der Veen MH, Lagerweij MD, Bokhout B, Prahl-Andersen B. Caries prevalence measured with QLF after treatment with fixed orthodontic appliances: Influencing factors. Caries Res. 2005; 39(1): 41–7.

Ahmed I, Saif-ul-Haque, Nazir R. Carious lesions in patients undergoing orthodontic treatment. J Pak Med Assoc. 2011; 61(12): 1176–9.

Tufekci E, Dixon JS, Gunsolley JC, Lindauer SJ. Prevalence of white spot lesions during orthodontic treatment with fixed appliances. Angle Orthod. 2011; 81(2): 206–10.

Sarver DM, Yanosky M. Principles of cosmetic dentistry in orthodontics: Part 3. Laser treatments for tooth eruption and soft tissue problems. Am J Orthod Dentofac Orthop. 2005; 127(2): 262–4.

van der Veen MH, Mattousch T, Boersma JG. Longitudinal development of caries lesions after orthodontic treatment evaluated by quantitative light-induced fluorescence. Am J Orthod Dentofac Orthop. 2007; 131(2): 223–8.

Parahitiyawa NB, Jin LJ, Leung WK, Yam WC, Samaranayake LP. Microbiology of odontogenic bacteremia: Beyond endocarditis. Clin Microbiol Rev. 2009; 22(1): 46–64.

do Nascimento LEAG, de Souza MMG, Azevedo ARP, Maia LC. Are self-ligating brackets related to less formation of Streptococcus mutans colonies? A systematic review. Dental Press J Orthod. 2014; 19(1): 60–8.

Kanaya T, Kaneko N, Amaike C, Fukushima M, Morita S, Miyazaki H, Saito I. A study on changes in caries risk and microbial flora with the placement of edgewise appliance. Orthod Waves. 2007; 66(2): 27–32.

Politangeli R, Sabatini S, Nardi GM, Di Giorgio R, Galluccio B. The filing of bacterial plaque on orthodontic appliances: type of bracket an motivational strengthening. Prev Res. 2015; 4(2): 70–4.

Gorelick L, Geiger AM, Gwinnet AJ. Incidence of white spot formation after bonding and banding. Am J Orthod. 1982; 81(2): 93–8.

Yılmaz H, Keleş S. Recent methods for diagnosis of dental caries in dentistry. Meandros Med Dent J. 2018; 19: 1–8.

Pratiwi ST. Mikrobiologi farmasi. Jakarta: Erlangga; 2008. p. 108–9.

Sudjalim TR, Woods MG, Manton DJ. Prevention of white spot lesions in orthodontic practice: A contemporary review. Aust Dent J. 2006; 51(4): 284–9.

Graber L, Vanarsdall R, Vig K. Orthodontics: current principles and techniques. 5th ed. Philadelphia: Mosby; 2011. p. 19–22, 517–34, 561–4.

Mayne RJ, Cochrane NJ, Cai F, Woods MG, Reynolds EC. In-vitro study of the effect of casein phosphopeptide amorphous calcium fluoride phosphate on iatrogenic damage to enamel during orthodontic adhesive removal. Am J Orthod Dentofac Orthop. 2011; 139(6): e543–51.

Ranganath LM, Shet RGK, Rajesh AG. Saliva: A powerful diagnostic tool for minimal intervention dentistry. J Contemp Dent Pract. 2012; 13(2): 240–5.


  • There are currently no refbacks.

View My Stats