Int J Stomatol

Int J Stomatol ›› 2025, Vol. 52 ›› Issue (5): 614-620.doi: 10.7518/gjkq.2025066

• Original Articles • Previous Articles     Next Articles

Relationship between enamel demineralization and oral microbiota with secretory immunoglobulin A in adolescent orthodontic patients

Kai Hu1(),Yanxiao Zhang2,Bingyong Mao1,Xin Tang1,Yueyan Wang3,Yue Pan2,Qiuxiang Zhang1(),Shumao Cui1   

  1. 1.School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
    2.Dept. of Orthodontics, Wuxi Stomatological Hospital, Wuxi 214000, China
    3.Dept. of Endodontics, Wuxi Stomatological Hospital, Wuxi 214000, China
  • Received:2024-04-08 Revised:2025-04-08 Online:2025-09-01 Published:2025-08-27
  • Contact: Qiuxiang Zhang E-mail:hkaimyt1999@gmail.com;zhangqx@jiangnan.edu.cn
  • Supported by:
    National Natural Science Foundation of China(32372300);Young and Middle-aged Researchers Project of Orthodontic Specialty Committee, Jiangsu Stomatological Association(Joa-2022-3);Jiangsu Provincial Key Laboratory of Oral Diseases Research Project(JSKLOD-KF-2108);Wuxi Municipal Health Commission General Program(M202338)

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Abstract:

Objective This study aimed to elucidate the key factors contributing to enamel demineralization in or-thodontic patients, identify biomarkers associated with its occurrence, and explore the relationship between enamel demine-ralization and oral microbiota in adolescent orthodontic patients. Methods Two groups of patients were selec-ted, one group with self-ligating brackets (Group S) and the other with traditional metal brackets (Group M), with 22 participants in each group. Subgingival plaque was collected for microbiome analysis at the baseline of orthodontic treatment and after 3 months. Simultaneously, saliva was collected to measure the levels of secretory immunoglobulin A (sIgA). Clinical indices such as the enamel demineralization index, plaque index (PLI), gingival index, and periodontal index were statistically analyzed during monthly recall visits. Results After 3 months of orthodontic treatment, the incidence of enamel demineralization among patients significantly increased, with an average increase of over 20% in demineralization rates. In Group S, the abundance of Fusobacterium, Campylobacter, Neisseria, and Prevotella significantly increased after 3 months of orthodontics (P<0.05). In Group M, the abundance of Rothia significantly increased (P<0.05). The abundance of Arthrobacter, Bacillus, Acinetobacter, Prevotella, and Campylobacter was positively correlated with enamel demineralization and PLI scores. The levels of sIgA in saliva were negatively correlated with the occurrence of enamel demineralization, with a significant decrease in sIgA levels in Group S after orthodontic treatment (P<0.01). Conclusion Orthodontic patients with self-ligating brackets are more prone to enamel demineralization, and Campylobacter and Prevotella may be key bacterial species that exacerbate enamel demineralization in adolescent orthodontic patients. A decrease in salivary sIgA levels may indicate an increased risk of enamel demineralization in or-thodontic patients.

Key words: orthodontics, enamel demineralization, oral microbiota, secretory immunoglobulin A

CLC Number: 

  • R781.5

TrendMD: 

Tab 1

Information of research subjects"

基本信息S组M组P值
年龄/岁13.4±1.914.3±1.80.997
性别/例男9100.228
女1312
身高/cm162.9±7.9166.5±7.80.996
体重/kg47±6.748.7±8.30.871
BMI/（kg/m2）17.6±2.017.5±2.50.819
每日刷牙频率/次110150.650
2127
≥300
每周高糖食物食用次数/次0820.774
1~21219
≥321

Tab 2

Clinical index of research subjects"

临床指标ST0占比/%ST3占比/%MT0占比/%MT3占比/%P值 （ST0vsST3）P值（MT0vsMT3）
EDIN=01464418167313590.0020.007
N=16271150523523
N=22941815418
N=3003140000
PLIN=0135941815687320.0070.003
N=17321150627627
N=22941815732
N=3003140029
PIN=019861986188217771.0000.998
N=1314314418523
N=200000000
N=300000000
GIN=01359627167311500.1150.530
N=194113596271045
N=2003140015
N=300000000

Fig 1

Analysis of the diversity of oral microbiota in two groups before and after orthodontic treatment"

Fig 2

Comparison of the abundance of oral microbiota in two groups"

Fig 3

Correlation analysis of oral health indicators in two groups"

[1] 周航, 蔡萍. 正畸治疗对牙周组织影响的研究进展[J]. 国际口腔医学杂志, 2011, 38(1): 109-111.
Zhou H, Cai P. Research progress on periodontal conditions in subjects following orthodontic therapy[J]. Int J Stomatol, 2011, 38(1): 109-111.
[2] 胡娟, 赵蔚萍, 付丽丽, 等. 直丝弓口腔正畸矫治力与患者正畸牙移动、龈沟液炎症反应程度的相关性分析[J]. 临床和实验医学杂志, 2023, 22(16): 1770-1773.
Hu J, Zhao WP, Fu LL, et al. Correlation analysis of orthodontic force of straight wire arch with ortho-dontic tooth movement and gingival crevicular fluid inflammation[J]. J Clin Exper Med, 2023, 22(16): 1770-1773.
[3] 王楠楠, 贺红, 花放. 正畸相关釉质脱矿危险因素的研究进展[J]. 国际口腔医学杂志, 2024, 51(1): 91-98.
Wang NN, He H, Hua F. Research progress on the risk factors of orthodontically induced enamel demineralization[J]. Int J Stomatol, 2024, 51(1): 91-98.
[4] 王启秋, 支清惠. 釉质白垩斑治疗方法的研究进展[J]. 国际口腔医学杂志, 2022, 49(6): 717-723.
Wang QQ, Zhi QH. Research progress on treatments of enamel white spot lesions[J]. Int J Stomatol, 2022, 49(6): 717-723.
[5] 刘育鑫, 侯夏佩, 谭国琴, 等. 固定正畸过程中牙面菌群变化与釉质脱矿相关性研究[J]. 西南国防医药, 2013, 23(3): 247-249.
Liu YX, Hou XP, Tan GQ, et al. A study on correlation between microflora changes on facing and enamel demineralization during fixed orthodontic treatment[J]. Southwest Nat Defen Med J, 2013, 23(3): 247-249.
[6] Bergamo AZN, Nelson-Filho P, Andrucioli MCD, et al. Microbial complexes levels in conventional and self-ligating brackets[J]. Clin Oral Investig, 2017, 21(4): 1037-1046.
[7] Lim BS, Kim BH, Shon WJ, et al. Effects of caries activity on compositions of mutans streptococci in saliva-induced biofilm formed on bracket materials[J]. Materials (Basel), 2020, 13(21): 4764.
[8] Costalonga M, Herzberg MC. The oral microbiome and the immunobiology of periodontal disease and caries[J]. Immunol Lett, 2014, 162(2 Pt A): 22-38.
[9] Huang L, Xu QA, Liu C, et al. Anti-caries DNA vaccine-induced secretory immunoglobulin A antibo-dies inhibit formation of Streptococcus mutans biofilms in vitro [J]. Acta Pharmacol Sin, 2013, 34(2): 239-246.
[10] 何文丹, 刘英志, 徐圆圆, 等. CPP-ACP在正畸治疗中防治牙面脱矿的应用[J]. 上海口腔医学, 2010, 19(2): 140-143.
He WD, Liu YZ, Xu YY, et al. Study on application of CPP-ACP on tooth mineralization during ortho-dontic treatment with fixed appliance[J]. Shanghai J Stomatol, 2010, 19(2): 140-143.
[11] Paszyńska E, Limanowska-Shaw H, Słopień A, et al. Evaluation of oral health in bulimia nervosa[J]. Psychiatr Pol, 2006, 40(1): 109-118.
[12] Simpson TC, Weldon JC, Worthington HV, et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus[J]. Cochrane Database Syst Rev, 2015, 2015(11): CD004714.
[13] James P, Worthington HV, Parnell C, et al. Chlorhe-xidine mouthrinse as an adjunctive treatment for gingival health[J]. Cochrane Database Syst Rev, 2017, 3(3): CD008676.
[14] Ye Y, Xu X, Mao B, et al. Evaluation of heat-inactivated Limosilactobacillus fermentum CCFM1139 and its supernatant for the relief of experimental periodontitis in rats[J]. Food Funct, 2023, 14(6): 2847-2856.
[15] Liu H, Liu H, Yan C, et al. Punicalagin alleviates hypercholesterolemia in mice through modulating farnesoid X receptor signaling and modulating gut microbiota[J]. Food Sci Hum Wellness, 2025, 14(1): 9250012.
[16] 杨加震, 张颖, 刘育含, 等. 口腔诊疗环境细菌群落的时间变化趋势研究[J]. 国际口腔医学杂志, 2022, 49(2): 132-137.
Yang JZ, Zhang Y, Liu YH, et al. Time variation trend of bacterial community in oral diagnosis and treatment environment[J]. Int J Stomatol, 2022, 49(2): 132-137.
[17] Marinelli G, Inchingolo AD, Inchingolo AM, et al. White spot lesions in orthodontics: prevention and treatment. A descriptive review[J]. J Biol Regul Homeost Agents, 2021, 35(2 ): 227-240.
[18] Su SC, Chang LC, Huang HD, et al. Oral microbial dysbiosis and its performance in predicting oral cancer[J]. Carcinogenesis, 2021, 42(1): 127-135.
[19] 刘敏, 王成祥, 张淼. 口腔精细护理模式对固定矫正器正畸患者牙菌斑及釉质脱矿的影响[J]. 包头医学, 2022, 46(1): 58-60.
Liu M, Wang CX, Zhang M. Effect of refined oral care on dental plaque and enamel demineralization in patients with fixed orthodontic appliances[J]. Baotou Med, 2022, 46(1): 58-60.
[20] Shokeen B, Viloria E, Duong E, et al. The impact of fixed orthodontic appliances and clear aligners on the oral microbiome and the association with clinical parameters: a longitudinal comparative study[J]. Am J Orthod Dentofacial Orthop, 2022, 161(5): e475-e485.
[21] 石晶, 彭惠. 自锁托槽与传统托槽对牙周环境影响的研究现状和进展[J]. 国际口腔医学杂志, 2012, 39(6): 824-827.
Shi J, Peng H. Clinical application status and prospects of self-ligating and conventional brackets on periodontal environments[J]. Int J Stomatol, 2012, 39(6): 824-827.
[22] 张晶晶, 王超, 王宏伟, 等. 无托槽隐形矫治器与固定矫治器对牙周病正畸治疗患者龈下菌群、龈沟液炎症因子和氧化应激的影响[J]. 现代生物医学进展, 2023, 23(10): 1945-1949.
Zhang JJ, Wang C, Wang HW, et al. Effects of non bracket invisible appliance and fixed appliance on subgingival flora, gingival crevicular fluid inflammatory factors and oxidative stress in patients with periodontal disease undergoing orthodontic treatment[J]. Prog Modern Biomed, 2023, 23(10): 1945-1949.
[23] Van der Reijden WA, Dellemijn-Kippuw N, Stijne-van Nes AM, et al. Mutans streptococci in subgingival plaque of treated and untreated patients with periodontitis[J]. J Clin Periodontol, 2001, 28(7): 686-691.
[24] Yang H, Ma Y, Xie X, et al. Candida albicans enriched in orthodontic derived white spot lesions and shaped focal supragingival bacteriome[J]. Front Microbiol, 2023, 14: 1084850.
[25] Zhang Q, Guan L, Guo J, et al. Application of fluoride disturbs plaque microecology and promotes remineralization of enamel initial caries[J]. J Oral Microbiol, 2022, 14(1): 2105022.
[26] Chawda JG, Chaduvula N, Patel HR, et al. Salivary sIgA and dental caries activity[J]. Indian Pediatr, 2011, 48(9): 719-721.
[27] Kugler J, Breitfeld I, Tewes U, et al. Excavation of caries lesions induces transient decrease of total salivary immunoglobulin A concentration[J]. Eur J Oral Sci, 1996, 104(1): 17-20.
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