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Abstract
Background: The application of fixed orthodontic appliances plays a crucial role in altering the oral biofilm, exposing patients to an increased risk of caries and periodontal diseases. For this reason, the literature consistently recommends the use of chlorhexidine and fluoride containing mouthwashes as adjuncts to routine oral hygiene practices. Furthermore, it is known that orthodontic appliance components are not sterile when removed from their packaging and should therefore undergo disinfection and sterilization before use. Aim: To evaluate whether commercially available mouthwashes, disinfectants and sterilizers can damage orthodontic components through analysis using scanning electron microscopy (SEM). Materials and Methods: Four commonly used components of fixed appliances were examined: brackets, Ni-Ti arch, metal ligatures and elastic ligatures. The substances tested for their effects on these components included two mouthwashes, two disinfectants, and one sterilizer. Each component was analyzed via SEM at two time points: T0, when untreated, and T2, after immersion in the respective solution for its designated action time, depending on intraoral and extraoral use. Results: The correlation analysis revealed no dependence of the KM width on the age and gender of patients and the type of teeth and jaws. The results indicated that the tested mouthwashes did not cause surface damage to the orthodontic components. Regarding the disinfectant and sterilizer, no surface damage was observed on brackets, arch, or metal ligatures; however, one disinfectant and the sterilizer caused noticeable surface deterioration of the elastic ligatures. During the year of follow-up, there were no dental implant failures in both groups, and the survival rate of implants one year after their installation was 100%. Conclusion: Metal alloy components (stainless steel and nickel – titanium) were not affected in vitro by either the disinfectants/sterilizers or the mouthwashes. Therefore, these substances can be used safely and comply with the healthcare professional’s obligation to maintain patient health. However, caution should be exercised in disinfecting elastic ligatures. Mouthwashes and chlorhexidine-based disinfectants were shown to have no damaging effects on elastic ligatures and can thus be safely employed for these components.
