{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T02:12:58Z","timestamp":1761271978486,"version":"build-2065373602"},"reference-count":40,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy Timisoara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Background and Objectives: Orthodontic auxiliaries create plaque-retentive niches that may amplify biofilm accumulation and inflame adjacent soft tissues. While cross-sectional comparisons suggest higher palatal burden beneath acrylic elements, less is known about real-world patterns accumulated across years of routine care. We retrospectively evaluated periodontal and palatal outcomes, and, in a microbiology sub-sample, site-specific colonization, across three device types: molar bands, Nance buttons, and removable acrylic plates. Methods: We reviewed 2022\u20132025 records from a university orthodontic service, including consecutive patients aged 18\u201330 years with documented pre-placement and 6-month follow-up indices. Groups were bands (n = 92), Nance (n = 78), acrylic (n = 76). Standardized charted measures were abstracted: Plaque Index (PI), Gingival Index (GI), bleeding on probing (BOP%), probing depth (PD), and palatal erythema grade (0\u20133). A laboratory sub-sample (n = 174 visits) had archived swabs cultured for total aerobic counts (log10 CFU\/cm2) at the device, adjacent enamel, and palatal mucosa; Streptococcus mutans burden was available from qPCR (log10 copies\/mL). Results: Baseline characteristics were similar, except for longer wear at follow-up in Nance (10.1 \u00b1 4.0 months) vs. bands (8.7 \u00b1 3.2) and acrylic (6.9 \u00b1 3.0; p &lt; 0.001). At 6 months, device type was associated with greater worsening of PI and GI (both p &lt; 0.001) and with higher palatal erythema (bands 0.7 \u00b1 0.5; Nance 1.6 \u00b1 0.8; acrylic 1.9 \u00b1 0.7; p &lt; 0.001). Microbiologically, palatal mucosal colonization was lowest with bands (3.3 \u00b1 0.5), higher with Nance (4.9 \u00b1 0.6), and highest with acrylic (5.0 \u00b1 0.7; p &lt; 0.001); S. mutans mirrored this gradient (p &lt; 0.001). Palatal CFU correlated with erythema (\u03c1 = 0.6, p &lt; 0.001) and \u0394GI (\u03c1 = 0.5, p &lt; 0.001). In adjusted models, acrylic (OR 6.7, 95% CI 3.5\u201312.8) and Nance (OR 4.9, 2.5\u20139.3) independently predicted erythema \u22652; recent prophylaxis reduced odds (OR 0.6, 0.3\u20130.9). Conclusions: In this single-center cohort, palate-contacting designs were associated with higher palatal biomass and erythema than bands. These associations support device-tailored hygiene considerations and proactive palatal surveillance, particularly for acrylic components.<\/jats:p>","DOI":"10.3390\/dj13110488","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T01:35:11Z","timestamp":1761269711000},"page":"488","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Retrospective Assessment of Palatal Biofilm and Mucosal Inflammation Under Orthodontic Appliances in Young Adults (2022\u20132025): A Single-Center Cohort with Microbiologic Sub-Sampling"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4170-1503","authenticated-orcid":false,"given":"Bianca","family":"Dragos","sequence":"first","affiliation":[{"name":"Doctoral School, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Research Centre in Dental Medicine Using Conventional and Alternative Technologies, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Blvd., 300070 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2401-690X","authenticated-orcid":false,"given":"Dana-Cristina","family":"Bratu","sequence":"additional","affiliation":[{"name":"Department of Orthodontics II, Orthodontic Research Centre, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5537-1253","authenticated-orcid":false,"given":"George","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Orthodontics II, Orthodontic Research Centre, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magda-Mihaela","family":"Luca","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry, Pediatric Dentistry Research Center, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Remus-Christian","family":"Bratu","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3642-1854","authenticated-orcid":false,"given":"Carina","family":"Neagu","sequence":"additional","affiliation":[{"name":"Department of Prostheses Technology and Dental Materials, Research Center in Dental Medicine Using Conventional and Alternative Technologies, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Blvd., 300070 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5651-7215","authenticated-orcid":false,"given":"Cosmin","family":"Sinescu","sequence":"additional","affiliation":[{"name":"Department of Prostheses Technology and Dental Materials, Research Center in Dental Medicine Using Conventional and Alternative Technologies, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Blvd., 300070 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"533","DOI":"10.3109\/00016356309011240","article-title":"Periodontal Disease in Pregnancy. I. Prevalence and Severity","volume":"21","author":"Loe","year":"1963","journal-title":"Acta Odontol. Scand."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1902\/jop.1967.38.6.610","article-title":"The Gingival Index, the Plaque Index and the Retention Index Systems","volume":"38","year":"1967","journal-title":"J. Periodontol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1111\/j.1600-051X.1986.tb00852.x","article-title":"Bleeding on probing. A predictor for the progression of periodontal disease?","volume":"13","author":"Lang","year":"1986","journal-title":"J. Clin. Periodontol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"614","DOI":"10.2174\/1745017901814010614","article-title":"Orthodontic Fixed Appliance and Periodontal Status: An Updated Systematic Review","volume":"12","author":"Cerroni","year":"2018","journal-title":"Open Dent. J."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Lucchese, A., Bondemark, L., Marcolina, M., and Manuelli, M. (2018). Changes in oral microbiota due to orthodontic appliances: A systematic review. J. Oral Microbiol., 10.","DOI":"10.1080\/20002297.2018.1476645"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1111\/ocr.12237","article-title":"Effect of orthodontic treatment on the subgingival microbiota: A systematic review and meta-analysis","volume":"21","author":"Papageorgiou","year":"2018","journal-title":"Orthod. Craniofac. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1590\/1678-775720130318","article-title":"Effect of fixed orthodontic appliances on salivary microbial parameters at 6 months: A controlled observational study","volume":"22","author":"Maret","year":"2014","journal-title":"J. Appl. Oral Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"309","DOI":"10.4103\/1735-3327.187876","article-title":"Evaluation of changes in Streptococcus mutans colonies in microflora of the Indian population with fixed orthodontics appliances","volume":"13","author":"Shukla","year":"2016","journal-title":"Dent. Res. J."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Kado, I., Hisatsune, J., Tsuruda, K., Tanimoto, K., and Sugai, M. (2020). The impact of fixed orthodontic appliances on oral microbiome dynamics in Japanese patients. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-78971-2"},{"key":"ref_10","first-page":"271","article-title":"Salivary Streptococcus Mutans and Lactobacillus spp. levels in patients during rapid palatal expansion","volume":"15","author":"Ortu","year":"2014","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"8685796","DOI":"10.1155\/2016\/8685796","article-title":"Bacterial Adhesion and Surface Roughness for Different Clinical Techniques for Acrylic Polymethyl Methacrylate","volume":"2016","author":"Dantas","year":"2016","journal-title":"Int. J. Dent."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Charavet, C., Graveline, L., Gourdain, Z., and Lupi, L. (2021). What Are the Cleaning and Disinfection Methods for Acrylic Orthodontic Removable Appliance? A Systematic Review. Children, 8.","DOI":"10.3390\/children8110967"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.1601-6343.2007.00396.x","article-title":"Clinical and microbiological effects of fixed orthodontic appliances on periodontal tissues in adolescents","volume":"10","author":"Ristic","year":"2007","journal-title":"Orthod. Craniofac. Res."},{"key":"ref_14","first-page":"e61171","article-title":"How Effective Are the Nance Appliance and Transpalatal Arch at Reinforcing Anchorage in Extraction Cases?","volume":"16","author":"Alrehaili","year":"2024","journal-title":"Cureus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1080\/14653125.2017.1334531","article-title":"Tissue necrosis under a Nance palatal arch: A case report","volume":"44","author":"Sullivan","year":"2017","journal-title":"J. Orthod."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"335","author":"Altman","year":"2007","journal-title":"BMJ"},{"key":"ref_17","first-page":"711","article-title":"Assessment of Oral Hygiene, Gingival, and Periodontal Health, and Teeth Eruption among Type 1 Diabetic Saudi Children","volume":"15","author":"Mandura","year":"2022","journal-title":"Int. J. Clin. Pediatr. Dent."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1373\/clinchem.2008.112797","article-title":"The MIQE guidelines: Minimum information for publication of quantitative real-time PCR experiments","volume":"55","author":"Bustin","year":"2009","journal-title":"Clin. Chem."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e475","DOI":"10.1016\/j.ajodo.2021.10.015","article-title":"The impact of fixed orthodontic appliances and clear aligners on the oral microbiome and the association with clinical parameters: A longitudinal comparative study","volume":"161","author":"Shokeen","year":"2022","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_20","first-page":"e1071","article-title":"Oral colonization by Candida species in orthodontic patients before, during and after treatment with fixed appliances: A prospective controlled trial","volume":"12","author":"Sheth","year":"2020","journal-title":"J. Clin. Exp. Dent."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.ajodo.2011.11.021","article-title":"Influence of thermoplastic retainers on Streptococcus mutans and Lactobacillus adhesion","volume":"141","year":"2012","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"34","DOI":"10.4103\/jos.jos_7_22","article-title":"Evaluation of biofilm formation on different clear orthodontic retainer materials","volume":"11","author":"Hamdoon","year":"2022","journal-title":"J. Orthod. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Velliyagounder, K., Ardeshna, A., and Shah, S. (2022). An In Vivo Study on the Development of Bacterial Microbiome on Clear Orthodontic Retainer. Dent. J., 10.","DOI":"10.3390\/dj10120239"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/j.1365-263X.2009.00988.x","article-title":"The effects of orthodontic appliances on Candida in the human mouth","volume":"19","author":"Hibino","year":"2009","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Brzezi\u0144ska-Zaj\u0105c, A., Syci\u0144ska-Dziarnowska, M., Spagnuolo, G., Szyszka-Sommerfeld, L., and Wo\u017aniak, K. (2023). Candida Species in Children Undergoing Orthodontic Treatment with Removable Appliances: A Pilot Study. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20064824"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"293","DOI":"10.4067\/S0716-10182016000300007","article-title":"Influencia de la aparatolog\u00eda ortod\u00f3ntica sobre la ocurrencia de Candida spp. en la cavidad oral [Influence of orthodontic appliances on the occurrence of Candida spp. in the oral cavity]","volume":"33","year":"2016","journal-title":"Rev. Chil. Infectol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1080\/14653125.2018.1445505","article-title":"Haematemesis related to orthodontic treatment with Nance palatal arch: A case report","volume":"45","author":"Patini","year":"2018","journal-title":"J. Orthod."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Vincent-Bugnas, S., Borsa, L., Gruss, A., and Lupi, L. (2021). Prioritization of predisposing factors of gingival hyperplasia during orthodontic treatment: The role of amount of biofilm. BMC Oral Health, 21.","DOI":"10.1186\/s12903-021-01433-2"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"17039","DOI":"10.1038\/s41405-018-0007-3","article-title":"Influence of mouth breathing on outcome of scaling and root planing in chronic periodontitis","volume":"4","author":"Kaur","year":"2018","journal-title":"BDJ Open."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Lin, L., Zhao, T., Qin, D., Hua, F., and He, H. (2022). The impact of mouth breathing on dentofacial development: A concise review. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.929165"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"S12","DOI":"10.1111\/jcpe.12341","article-title":"Professional mechanical plaque removal for prevention of periodontal diseases in adults--systematic review update","volume":"42","author":"Needleman","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_32","first-page":"CD004625","article-title":"Routine scale and polish for periodontal health in adults","volume":"12","author":"Lamont","year":"2018","journal-title":"Cochrane Database Syst Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1093\/ejo\/cjac044","article-title":"Effects of chlorhexidine use on periodontal health during fixed appliance orthodontic treatment: A systematic review and meta-analysis","volume":"45","author":"Hussain","year":"2023","journal-title":"Eur. J. Orthod."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Ren, X., Zhang, Y., Xiang, Y., Hu, T., Cheng, R., and Cai, H. (2023). The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment: A systematic review and meta-analysis. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-02920-4"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1179\/1465313313Y.0000000088","article-title":"An assessment of the effectiveness of mechanical and chemical cleaning of Essix orthodontic retainer","volume":"41","author":"Chang","year":"2014","journal-title":"J. Orthod."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"9920850","DOI":"10.1155\/2023\/9920850","article-title":"Effect of Different Cleaning Regimes on Biofilm Formation of Acrylic-Based Removable Orthodontic Appliance: A Randomized Clinical Trial","volume":"2023","author":"Khawwam","year":"2023","journal-title":"Sci. World J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.ajodo.2015.07.031","article-title":"Streptococcus mutans counts in patients wearing removable retainers with silver nanoparticles vs those wearing conventional retainers: A randomized clinical trial","volume":"149","author":"Farhadian","year":"2016","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_38","first-page":"CD003809","article-title":"Fluorides for preventing early tooth decay (demineralised lesions) during fixed brace treatment","volume":"2019","author":"Benson","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"77","DOI":"10.34172\/joddd.2020.019","article-title":"Assessment of surface roughness changes on orthodontic acrylic resins by all-in-one spray disinfectant solutions","volume":"14","author":"Hsu","year":"2020","journal-title":"J. Dent. Res. Dent. Clin. Dent. Prospect."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Schiller, L.A., Barbu, H.M., Iancu, S.A., and Brad, S. (2022). Incidence, Size and Orientation of Maxillary Sinus Septa\u2014A Retrospective Clinical Study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11092393"}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/11\/488\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T02:08:17Z","timestamp":1761271697000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/11\/488"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":40,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["dj13110488"],"URL":"https:\/\/doi.org\/10.3390\/dj13110488","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,23]]}}}