Comparison and evaluation of oral streptococcus mutans count and salivary pH in patients treated with removable twin block appliance - an in vivo study

The oral cavity contains over 800 bacterial species that form biofilms on hard and soft tissues. Orthodontic treatments can make oral hygiene maintenance challenging, leading to demineralization and dental plaque formation.

Streptococcus mutans are primary bacteria responsible for dental caries, with it playing a critical role in the initiation of dental caries. Orthodontic treatments can increase Streptococcus mutans count up to five-fold, leading to plaque-mediated conditions like gingivitis, periodontitis, stomatitis, and dental caries.

Twin block appliance consist of simple maxillary and mandibular bite blocks that interlock at a 70-degree angle, causing functional displacement of the mandible and correcting maxillo-mandibular relationships.

Understanding oral microbiota changes during various procedures is essential for educating patients about oral hygiene maintenance. In this study, patients who met the inclusion and exclusion criteria will be instructed on proper oral hygiene and appliance maintenance. Unstimulated saliva will be collected at three time points: before appliance delivery, 1 month after appliance delivery, and 6 months after appliance delivery. Salivary pH will be measured, and streptococcus mutans colonies to be cultured and counted.

Statistical analysis using independent t-tests will be performed to evaluate salivary streptococcus mutans count at the mentioned time points in the study group and control group. The significance level is set at P < 0.05. This study provides valuable insights into the effects of removable twin block appliances on oral streptococcus mutans colonization levels and salivary pH, which can inform dental practitioners and patients on proper oral hygiene practices during orthopaedic treatment. Also this study will help orthodontists get motivated for the usage of growth modulation appliances and its applications in the field of orthodontics and encourage them to actively participate in Dentofacial Orthopaedics and its applications.