Comparison of Streptococcus mutans adhesion to fixed orthodontic wires in different types of saliva under laboratory conditions

Comparison of Streptococcus mutans adhesion to fixed orthodontic wires in different types of saliva under laboratory conditions | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Comparison of Streptococcus mutans adhesion to fixed orthodontic wires in different types of saliva under laboratory conditions Ahmad SheibaniNia This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6058536/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objectives: This study investigates the adhesion of Streptococcus mutans to fixed orthodontic wires in varying types of saliva under laboratory conditions, given the heightened microbial load and increased caries prevalence in patients with orthodontic appliances. Methods and Materials : Stainless steel wires and nickel-titanium wires of the same dimensions were utilized, with six samples per group. After preparation and sterilization, the samples were immersed for two hours in artificial saliva solutions with either normal or acidic pH. Subsequently, the samples were incubated in a S. mutans suspension. Following serial dilution and cultivation on BHI agar, the number of former colonies was counted. The results were analyzed using two-way ANOVA with a significance level at p ≤ 0.05. Results: The adhesion rate of S. mutans to stainless steel archwires was significantly higher than that to nickel-titanium archwires in both acidic and normal saliva ( p ≤ 0.05). Moreover, the adhesion rate to both archwires was lower in acidic saliva compared to normal saliva ( p ≤ 0.05). Conclusion: S. mutans exhibits a lower adhesion rate to nickel-titanium archwires compared to stainless steel archwires in both acidic and normal saliva. Acidic saliva Orthodontic treatment Orthodontic wires Streptococcus mutans Introduction Modern orthodontic treatments encompass a series of orthodontic and orthognathic interventions aimed at aligning the soft tissue with the position of the teeth and achieving functional occlusion. These procedures are commonly performed by orthodontists to adjust the position of the teeth or the jaw, thereby enhancing soft tissue relationships and creating functional occlusion [ 1 ]. Furthermore, the importance of frequent dental examinations during orthodontic treatment is well recognized among orthodontists, as studies have shown that patients undergoing fixed orthodontic treatment are at a higher risk for caries and periodontal problems compared to others [ 2 ]. Results of investigations indicates that 96% of orthodontic patients develop at least one white lesion during treatment, predominantly on the buccal surface of the upper anterior teeth near the brackets [ 3 ]. It has also been observed that patients with a high risk of caries before treatment tend to have higher levels of Streptococcus mutans in their saliva during treatment [ 1 ]. This is attributed to the rapid alteration of oral flora favoring pathogenic microorganisms after the commencement of treatment with fixed appliances and a decrease in salivary pH three months into treatment, contributing to the acidification of the oral environment and the appearance of white lesions [ 4 , 5 ]. The use of intraoral appliances, such as archwires and other orthodontic tools, increases the accumulation of caries-causing microorganisms by enhancing contact points and limiting toothbrush access to all dental surfaces. In general, the use of fixed intraoral appliances increases the available surfaces for microorganism attachment, thereby enhancing the potential for biofilm formation [ 6 ]. A crucial study comparing the amount of S. mutans in orthodontic patients with active caries to those without dental caries revealed that the number of S. mutans in orthodontic patients is influenced by the number of teeth with active caries [ 7 ]. Orthodontic treatment is thus a risk factor for periodontal diseases and caries, with an increase in cariogenic microorganisms like S. mutans leading to enamel and dentin demineralization and eventual caries in this patient group [ 8 – 10 ]. Controlling plaque indicators in patients before treatment is essential. Therefore, understanding the degree of S. mutans adhesion to commonly used orthodontic wires, such as stainless steel and nickel-titanium, is crucial for selecting appropriate orthodontic archwires based on the type of saliva. A review of previous studies reveals a lack of sufficient information on the extent of S. mutans adhesion to fixed orthodontic materials and devices, indicating a knowledge gap in this area. Therefore, the purpose of this study is to compare the extent of S. mutans adhesion to fixed orthodontic wires in different types of saliva under laboratory conditions. Methods This in vitro study was investigated the adhesion of S. mutans to stainless steel and nickel-titanium orthodontic wires, both measuring 0.016 x 0.022 inches. According to Junior et al. [ 11 ], the required sample size was calculated using the fixed effects ANOVA analysis by SPSS software, with α = 0.05 and β = 0.2 for the material type variable and β = 0.01 for the saliva type variable. The effect size was 0.6 for the material type and 1.5 for the saliva type, resulting in a minimum of six samples per subgroup. S. mutans UA159 (ATCC 700610) was obtained from the National Center for Genetic and Biological Resources of Iran. The bacteria were cultured in brain heart infusion medium with 100 mM glucose at 37°C under 10% CO 2 . After 24–48 hours, bacterial cells were centrifuged at 3,000 g, washed twice with sterile 145 mM NaCl, and re-suspended to a concentration of 1.5 × 10 8 CFU/mL, confirmed spectrophotometrically at 620 nm [ 11 ]. Artificial saliva, replicating natural saliva’s composition, was procured from Arad Company. Two groups of artificial saliva were prepared: one with a normal pH and one with an acidic pH. Phosphate-buffered saline with pH 7.2 served as the control group [ 12 ]. The study included stainless steel archwires and nickel-titanium archwires (American Orthodontics, USA). Each subgroup was immersed in artificial saliva for 2 hours to facilitate pellicle formation, and then incubated at 37°C and 5% CO 2 in a S. mutans suspension [ 11 , 13 ]. Archwires (10 mm long) were disinfected using an ultrasonic device (Mini Sono Cleaner CA 1470, Kaijo Denki Co. Ltd., Tokyo, Japan) for 15 min, followed by immersion in 70% alcohol for 30 min. Sterility was confirmed using BHI culture medium for 24 hours [ 13 ]. Post-incubation, the samples were washed thrice with 500 µL of 0.9% saline to remove unattached bacteria. The samples were then sonicated at 50% strength (Qsonica 125, Newtown, CT, USA) in 10 mL of 0.9% saline for 3 seconds. The resulting suspensions were serially diluted, and 10 µL of each dilution was cultured on BHI agar using the dropwise method, in six replicates. The culture plates were incubated at 37 ± 1°C for 48 hours, after which colony-forming units (CFUs) were counted using the pour plate method [ 14 ]. The data were analyzed using two-way ANOVA with a significance level at p ≤ 0.05 by SPSS. Results The effect of experimental factors and artificial saliva pH on the amount of S. mutans bacteria indicated that the factors of orthodontic wire type and pH had significantly impact on S. mutans colonies (Table 1 ). S. mutans colonies formed in saliva with a pH equal to 5 in stainless steel wires was 5.2 times more than the group of nickel titanium orthodontic wires (Table 1 ). The number of S. mutans colonies formed in saliva with a pH of 7 in the group of nickel-titanium orthodontic wires was 429,280 and 1,104,056 in stainless steel wires, which is 2.57 times more than the nickel titanium ( p ≤ 0.05). Table 1 Descriptive results of the number of S. mutans colonies formed on each of the orthodontic wires in all types of saliva pH Material Number of bacterial colonies ± SD (CFU/mL) P-value 5 SS 177526 ± 61650 0.000 NiTi 33896 ± 7325 7 SS 1104056 ± 110435 0.000 NiTi 429280 ± 96453 According to the results shown in Table 2 , there is a significant difference between the amounts of bacteria at pH 5 and 7 in all groups. The amount of bacteria attached to NiTi orthodontic wires at pH 7 is more than 5 ( p ≤ 0.05). The amount of bacteria attached to SS orthodontic wires at pH 7 is more than pH 5 ( p ≤ 0.05). Table 2 Comparison of the amount of S. mutans bacteria in the studied groups in acidic and normal saliva Material pH Mean Std. Deviation Std. Error Mean P-value SS 7 1104056.66 110435.55 45085.12 0.000 5 177526.66 61650.29 25168.63 NiTi 7 429280 96453.49 39376.98 0.000 5 33896.66 7325.64 2990.68 Discussion The present study demonstrates the significant role of orthodontic wires in the colonization of microorganisms. Specifically, it was found that S. mutans attachment is lower on nickel-titanium wires compared to stainless steel wires in both normal and acidic saliva conditions. A key contributing factor is the greater release of metal ions from NiTi wires, which imparts antibacterial properties [ 15 ]. Hepyukselen et al. [ 16 ] noted that NiTi wires, particularly those coated with other metals such as copper, exhibit enhanced antibacterial properties, reducing the likelihood of colonization by Streptococcus and Lactobacillus species. Eldriny et al. [ 17 ] reported higher adhesion rates on SS wires, which significantly decreased following the use of a natural antibacterial mouthwash. Polke et al. [ 18 ] found that biofilm accumulation was significant across all wire types, with the highest accumulation on TMA samples and the least on coated SS samples. Another significant finding is the higher bacterial colonization in normal saliva compared to acidic saliva. Similarly, Laird et al. [ 19 ] reported that low pH conditions increase the release of metal ions from orthodontic wires, enhancing their antibacterial properties and reducing S. mutans attachment, however, this study did not examine different incubation times, it highlighted the influence of saliva pH on bacterial attachment, showing increased bacterial binding in normal saliva compared to acidic conditions. S. mutans is known for its acidogenic properties, producing acidic compounds that inhibit the growth and attachment of certain streptococcal species. The prevalence of S. mutans has been a focal point of research for patients undergoing orthodontic treatment [ 2 , 20 ]. This comprehensive laboratory study compared two widely used types of orthodontic wires—stainless steel and nickel-titanium—under normal and acidic saliva conditions. The results indicate that both the type of orthodontic wire and the saliva pH significantly affect the binding rate of bacteria. Saliva and the formation of a salivary pellicle on orthodontic appliances reduce S. mutans binding. This reduction is partly due to the presence of lysozyme enzymes, histatins, and antibacterial elements in saliva, but mainly due to salivary pellicles. Certain salivary proteins, such as cystatins, amylase, immunoglobulin A, and mucin-7 (MG2), have a high affinity for binding to bracket surfaces and simultaneously possess active receptors for microorganisms. Ahn et al. [ 21 ] found that S, gordonii has a high affinity for binding to MG2 salivary pellicles and amylases, whereas S. mutans does not, as these pellicles do not provide suitable receptors for it. Two other critical factors influencing the attachment of microorganisms are surface free energy and surface topography. A saliva coating reduces the surface energy, thereby decreasing the probability of bacteria attachment [ 22 ]. The presence of orthodontic appliances alters the oral environment, fostering the growth and accumulation of cariogenic microorganisms. This study indicates that SS archwires significantly increase S. mutans colonization, thereby elevating the risk of dental caries and white lesions. One of the strengths of this study is its use of two types of saliva to simulate normal and carious conditions. However, a limitation is the lack of clinical conditions and other influencing factors in salivary caries. This laboratory study aids in making informed decisions about treatment plans and the selection of materials and devices for patients at high risk of caries, laying the groundwork for future clinical studies. Based on the results, it is recommended to use nickel-titanium wires as much as possible in patients with a high risk of caries. Declarations Funding The author declares that no funds, grants, or other support were received during the preparation of this manuscript. Ethical approval Not Applicable. Competing interests The author declares no competing interests. Informed Consent Not Applicable. References Mirmohammadi K, Sheibani Nia A, Safarzadeh Khosroshahi S, Shokouhi Mostafavi SK (2024) In vitro comparison of Streptococcus mutans adhesion to orthodontic composites in various types of saliva. Res Dent Sci 21: 281-291. https://doi.org/10.61186/jrds.21 .4.281 Ahmed I, Saif-ul-Haque RN (2011) Carious lesions in patients undergoing orthodontic treatment. JPMA 61 . Martignon S, Ekstrand K, Lemos M, Lozano M, Higuera C (2010) Plaque, caries level and oral hygiene habits in young patients receiving orthodontic treatment. Community dental health 27: 133-138 . Rosenbloom RG, Tinanoff N (1991) Salivary Streptococcus mutans levels in patients before, during, and after orthodontic treatment. Am J Orthod Dentofac Orthop 100: 35-37. https://doi.org/10.1016 /0889-5406(91)70046- Y Cardoso AA, Lopes LM, Rodrigues LP, Teixeira JJ, Steiner‐Oliveira C, et al. (2017) Influence of salivary parameters in the caries development in orthodontic patients—an observational clinical study. Int J Paediatr Dent 27: 540-550 . https://doi.org/10.1111/ipd.12295 Lucchese A, Bondemark L, Marcolina M, Manuelli M (2018) Changes in oral microbiota due to orthodontic appliances: a systematic review. J Oral Microbiol 10: 1476645. https://doi.org/10.1080/20002297.2018.1476645 Lim BS, Kim BH, Shon WJ, Ahn SJ (2020) Effects of caries activity on compositions of mutans streptococci in Saliva-Induced biofilm formed on bracket materials. Materials (Basel) 13. https://doi.org/10.3390/ma13214764 Contaldo M, Lucchese A, Lajolo C, Rupe C, Di Stasio D, et al. (2021) The oral microbiota changes in orthodontic patients and effects on oral health: An overview. J Clin Med 10: 780. https://doi.org/10.3390/jcm10040780 . da Costa Rosa T, de Almeida Neves A, Azcarate-Peril MA, Divaris K, Wu D, et al. (2021) The bacterial microbiome and metabolome in caries progression and arrest. J Oral Microbiol 13: 1886748. https://doi.org/10.1080/20002297.2021.1886748 Belvirdy LM, Sheibaninia A, Khosroshahi SS, Mostafavi SKS, Fard MJK (2024) Comparison of Streptococcus mutans adhesion with different concentrations in artificial saliva to fixed orthodontic materials in laboratory conditions. Biomedical and Biotechnology Research Journal (BBRJ) 8: 428-433 . do Rosário Junior AF, Knop LA, Baboni FB , Rymovicz AU, Tanaka OM, et al. (2011) Differential adhesion of Streptococcus mutan s to metallic brackets induced by saliva from caries-free and caries-active individuals. J Investig Clin Dent 2: 197-200. https://doi.org/10.1111/j.2041-1626.2011.00058.x J JP-P, Jakubik A, Przeklasa-Bierowiec A, Muszynska B (2017) Artificial saliva and its use in biological experiments. J Physiol Pharmacol 68: 807-813 . Shalchi M, Hajian-Tilaki A, khanjani MS, Sabzgolin P, Aghajani Nargesi R (2018) Comparing Streptococcus mutans adhesion using different orthodontic bracket ligations: An in vitro study. J Dentomaxillofacial Radiol Pathol Surg 7: 7-12. https://doi.org/10.32598/3dj.7.1.7 Arango-Santander S, Gonzalez C, Aguilar A, Cano A, Castro S, et al. (2020) Assessment of Streptococcus mutans adhesion to the surface of biomimetically-modified orthodontic archwires. Coatings 10: 201-210. https://doi.org/10.3390/coatings10030201 Hussain HD, Ajith SD, Goel P (2016) Nickel release from stainless steel and nickel titanium archwires - An in vitro study. J Oral Biol Craniofac Res 6: 213-218. https://doi.org/10.1016/j.jobcr.2016.06.001 Hepyukselen BG, Cesur MG (2019) Comparison of the microbial flora from different orthodontic archwires using a cultivation method and PCR: A prospective study. Orthod Craniofac Res 22: 354-360. https://doi.org/10.1111/ocr.12335 ELdriny AM, Ibrahim SA, Abdel Samad FA, Ali HA (2020) Evaluation of the ddhesion of Streptococcus mutans to different orthodontic arch wires and the effect of honey mouth wash on it. Al-Azhar Dent J Girls 7: 643-648. https://doi.org/10.21608/adjg.2020.17843.1198 Polke P, Jain U, Marothiya S, Agrawal P, Dixit S, et al. (2021) Comparative evaluation of biofilm adhesion to different types of archwire and microbiological colonization during orthodontic treatment. J Indian Orthod Soc 55: 150-157. https://doi.org/10.1177/0301574220957794 Laird C, Xu X, Yu Q, Armbruster P, Ballard R (2021) Nickel and chromium ion release from coated and uncoated orthodontic archwires under different pH levels and exposure times. J Oral Biosci 63: 450-454. https://doi.org/10.1016/j.job.2021.10.007 Arab S, Malekshah SN, Mehrizi EA, Khanghah AE, Naseh R, et al. (2016) Effect of fixed orthodontic treatment on salivary flow, pH and microbial count. J Dent (Tehran) 13: 18 . Ahn S-J, Kho H-S, Lee S-W, Nahm D-S (2002) Roles of salivary proteins in the adherence of oral streptococci to various orthodontic brackets. J Dent Res 81: 411-415. https://doi.org/10.1177/1544059 10208100611 Fatani EJ, Almutairi HH, Alharbi AO, Alnakhli YO, Divakar DD, et al. (2017) In vitro assessment of stainless steel orthodontic brackets coated with titanium oxide mixed Ag for anti-adherent and antibacterial properties against Streptococcus mutans and Porphyromonas gingivalis . Microb Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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These procedures are commonly performed by orthodontists to adjust the position of the teeth or the jaw, thereby enhancing soft tissue relationships and creating functional occlusion [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Furthermore, the importance of frequent dental examinations during orthodontic treatment is well recognized among orthodontists, as studies have shown that patients undergoing fixed orthodontic treatment are at a higher risk for caries and periodontal problems compared to others [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Results of investigations indicates that 96% of orthodontic patients develop at least one white lesion during treatment, predominantly on the buccal surface of the upper anterior teeth near the brackets [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. It has also been observed that patients with a high risk of caries before treatment tend to have higher levels of \u003cem\u003eStreptococcus mutans\u003c/em\u003e in their saliva during treatment [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This is attributed to the rapid alteration of oral flora favoring pathogenic microorganisms after the commencement of treatment with fixed appliances and a decrease in salivary pH three months into treatment, contributing to the acidification of the oral environment and the appearance of white lesions [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe use of intraoral appliances, such as archwires and other orthodontic tools, increases the accumulation of caries-causing microorganisms by enhancing contact points and limiting toothbrush access to all dental surfaces. In general, the use of fixed intraoral appliances increases the available surfaces for microorganism attachment, thereby enhancing the potential for biofilm formation [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA crucial study comparing the amount of \u003cem\u003eS. mutans\u003c/em\u003e in orthodontic patients with active caries to those without dental caries revealed that the number of \u003cem\u003eS. mutans\u003c/em\u003e in orthodontic patients is influenced by the number of teeth with active caries [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Orthodontic treatment is thus a risk factor for periodontal diseases and caries, with an increase in cariogenic microorganisms like \u003cem\u003eS. mutans\u003c/em\u003e leading to enamel and dentin demineralization and eventual caries in this patient group [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eControlling plaque indicators in patients before treatment is essential. Therefore, understanding the degree of \u003cem\u003eS. mutans\u003c/em\u003e adhesion to commonly used orthodontic wires, such as stainless steel and nickel-titanium, is crucial for selecting appropriate orthodontic archwires based on the type of saliva. A review of previous studies reveals a lack of sufficient information on the extent of \u003cem\u003eS. mutans\u003c/em\u003e adhesion to fixed orthodontic materials and devices, indicating a knowledge gap in this area. Therefore, the purpose of this study is to compare the extent of \u003cem\u003eS. mutans\u003c/em\u003e adhesion to fixed orthodontic wires in different types of saliva under laboratory conditions.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis \u003cem\u003ein vitro\u003c/em\u003e study was investigated the adhesion of \u003cem\u003eS. mutans\u003c/em\u003e to stainless steel and nickel-titanium orthodontic wires, both measuring 0.016 x 0.022 inches. According to Junior et al. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], the required sample size was calculated using the fixed effects ANOVA analysis by SPSS software, with α\u0026thinsp;=\u0026thinsp;0.05 and β\u0026thinsp;=\u0026thinsp;0.2 for the material type variable and β\u0026thinsp;=\u0026thinsp;0.01 for the saliva type variable. The effect size was 0.6 for the material type and 1.5 for the saliva type, resulting in a minimum of six samples per subgroup.\u003c/p\u003e \u003cp\u003e \u003cem\u003eS. mutans\u003c/em\u003e UA159 (ATCC 700610) was obtained from the National Center for Genetic and Biological Resources of Iran. The bacteria were cultured in brain heart infusion medium with 100 mM glucose at 37\u0026deg;C under 10% CO\u003csub\u003e2\u003c/sub\u003e. After 24\u0026ndash;48 hours, bacterial cells were centrifuged at 3,000 g, washed twice with sterile 145 mM NaCl, and re-suspended to a concentration of 1.5 \u0026times; 10\u003csup\u003e8\u003c/sup\u003e CFU/mL, confirmed spectrophotometrically at 620 nm [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eArtificial saliva, replicating natural saliva\u0026rsquo;s composition, was procured from Arad Company. Two groups of artificial saliva were prepared: one with a normal pH and one with an acidic pH. Phosphate-buffered saline with pH 7.2 served as the control group [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe study included stainless steel archwires and nickel-titanium archwires (American Orthodontics, USA). Each subgroup was immersed in artificial saliva for 2 hours to facilitate pellicle formation, and then incubated at 37\u0026deg;C and 5% CO\u003csub\u003e2\u003c/sub\u003e in a \u003cem\u003eS. mutans\u003c/em\u003e suspension [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eArchwires (10 mm long) were disinfected using an ultrasonic device (Mini Sono Cleaner CA 1470, Kaijo Denki Co. Ltd., Tokyo, Japan) for 15 min, followed by immersion in 70% alcohol for 30 min. Sterility was confirmed using BHI culture medium for 24 hours [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Post-incubation, the samples were washed thrice with 500 \u0026micro;L of 0.9% saline to remove unattached bacteria. The samples were then sonicated at 50% strength (Qsonica 125, Newtown, CT, USA) in 10 mL of 0.9% saline for 3 seconds. The resulting suspensions were serially diluted, and 10 \u0026micro;L of each dilution was cultured on BHI agar using the dropwise method, in six replicates. The culture plates were incubated at 37\u0026thinsp;\u0026plusmn;\u0026thinsp;1\u0026deg;C for 48 hours, after which colony-forming units (CFUs) were counted using the pour plate method [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The data were analyzed using two-way ANOVA with a significance level at \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026le;\u0026thinsp;0.05 by SPSS.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe effect of experimental factors and artificial saliva pH on the amount of \u003cem\u003eS. mutans\u003c/em\u003e bacteria indicated that the factors of orthodontic wire type and pH had significantly impact on \u003cem\u003eS. mutans\u003c/em\u003e colonies (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). \u003cem\u003eS. mutans\u003c/em\u003e colonies formed in saliva with a pH equal to 5 in stainless steel wires was 5.2 times more than the group of nickel titanium orthodontic wires (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The number of \u003cem\u003eS. mutans\u003c/em\u003e colonies formed in saliva with a pH of 7 in the group of nickel-titanium orthodontic wires was 429,280 and 1,104,056 in stainless steel wires, which is 2.57 times more than the nickel titanium (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026le;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive results of the number of \u003cem\u003eS. mutans\u003c/em\u003e colonies formed on each of the orthodontic wires in all types of saliva\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003epH\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaterial\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber of bacterial colonies\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (CFU/mL)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e177526\u0026thinsp;\u0026plusmn;\u0026thinsp;61650\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNiTi\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e33896\u0026thinsp;\u0026plusmn;\u0026thinsp;7325\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1104056\u0026thinsp;\u0026plusmn;\u0026thinsp;110435\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNiTi\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e429280\u0026thinsp;\u0026plusmn;\u0026thinsp;96453\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAccording to the results shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, there is a significant difference between the amounts of bacteria at pH 5 and 7 in all groups. The amount of bacteria attached to NiTi orthodontic wires at pH 7 is more than 5 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026le;\u0026thinsp;0.05). The amount of bacteria attached to SS orthodontic wires at pH 7 is more than pH 5 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026le;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of the amount of \u003cem\u003eS. mutans\u003c/em\u003e bacteria in the studied groups in acidic and normal saliva\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaterial\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003epH\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStd. Deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStd. Error Mean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1104056.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e110435.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e45085.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e177526.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61650.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25168.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNiTi\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e429280\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e96453.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e39376.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33896.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7325.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2990.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present study demonstrates the significant role of orthodontic wires in the colonization of microorganisms. Specifically, it was found that \u003cem\u003eS. mutans\u003c/em\u003e attachment is lower on nickel-titanium wires compared to stainless steel wires in both normal and acidic saliva conditions. A key contributing factor is the greater release of metal ions from NiTi wires, which imparts antibacterial properties [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Hepyukselen et al. [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] noted that NiTi wires, particularly those coated with other metals such as copper, exhibit enhanced antibacterial properties, reducing the likelihood of colonization by \u003cem\u003eStreptococcus\u003c/em\u003e and \u003cem\u003eLactobacillus\u003c/em\u003e species. Eldriny et al. [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] reported higher adhesion rates on SS wires, which significantly decreased following the use of a natural antibacterial mouthwash. Polke et al. [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] found that biofilm accumulation was significant across all wire types, with the highest accumulation on TMA samples and the least on coated SS samples.\u003c/p\u003e \u003cp\u003eAnother significant finding is the higher bacterial colonization in normal saliva compared to acidic saliva. Similarly, Laird et al. [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] reported that low pH conditions increase the release of metal ions from orthodontic wires, enhancing their antibacterial properties and reducing \u003cem\u003eS. mutans\u003c/em\u003e attachment, however, this study did not examine different incubation times, it highlighted the influence of saliva pH on bacterial attachment, showing increased bacterial binding in normal saliva compared to acidic conditions.\u003c/p\u003e \u003cp\u003e \u003cem\u003eS. mutans\u003c/em\u003e is known for its acidogenic properties, producing acidic compounds that inhibit the growth and attachment of certain streptococcal species. The prevalence of \u003cem\u003eS. mutans\u003c/em\u003e has been a focal point of research for patients undergoing orthodontic treatment [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. This comprehensive laboratory study compared two widely used types of orthodontic wires\u0026mdash;stainless steel and nickel-titanium\u0026mdash;under normal and acidic saliva conditions. The results indicate that both the type of orthodontic wire and the saliva pH significantly affect the binding rate of bacteria. Saliva and the formation of a salivary pellicle on orthodontic appliances reduce \u003cem\u003eS. mutans\u003c/em\u003e binding. This reduction is partly due to the presence of lysozyme enzymes, histatins, and antibacterial elements in saliva, but mainly due to salivary pellicles. Certain salivary proteins, such as cystatins, amylase, immunoglobulin A, and mucin-7 (MG2), have a high affinity for binding to bracket surfaces and simultaneously possess active receptors for microorganisms. Ahn et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] found that \u003cem\u003eS, gordonii\u003c/em\u003e has a high affinity for binding to MG2 salivary pellicles and amylases, whereas \u003cem\u003eS. mutans\u003c/em\u003e does not, as these pellicles do not provide suitable receptors for it. Two other critical factors influencing the attachment of microorganisms are surface free energy and surface topography. A saliva coating reduces the surface energy, thereby decreasing the probability of bacteria attachment [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe presence of orthodontic appliances alters the oral environment, fostering the growth and accumulation of cariogenic microorganisms. This study indicates that SS archwires significantly increase \u003cem\u003eS. mutans\u003c/em\u003e colonization, thereby elevating the risk of dental caries and white lesions.\u003c/p\u003e \u003cp\u003eOne of the strengths of this study is its use of two types of saliva to simulate normal and carious conditions. However, a limitation is the lack of clinical conditions and other influencing factors in salivary caries. This laboratory study aids in making informed decisions about treatment plans and the selection of materials and devices for patients at high risk of caries, laying the groundwork for future clinical studies. Based on the results, it is recommended to use nickel-titanium wires as much as possible in patients with a high risk of caries.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003eThe author declares that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003eEthical approval\u0026nbsp;Not Applicable.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u0026nbsp;The author declares no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent\u003c/strong\u003e Not Applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMirmohammadi K, Sheibani Nia A, Safarzadeh Khosroshahi S, Shokouhi Mostafavi SK (2024) In vitro comparison of \u003cem\u003eStreptococcus mutans\u003c/em\u003e adhesion to orthodontic composites in various types of saliva. 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(2020) Assessment of \u003cem\u003eStreptococcus mutans\u003c/em\u003e adhesion to the surface of biomimetically-modified orthodontic archwires. Coatings 10: 201-210. https://doi.org/10.3390/coatings10030201\u003c/li\u003e\n\u003cli\u003eHussain HD, Ajith SD, Goel P (2016) Nickel release from stainless steel and nickel\u003cspan dir=\"RTL\"\u003e \u003c/span\u003etitanium archwires - An in vitro study. J Oral Biol Craniofac Res 6: 213-218. https://doi.org/10.1016/j.jobcr.2016.06.001\u003c/li\u003e\n\u003cli\u003eHepyukselen BG, Cesur MG (2019) Comparison of the microbial flora from different orthodontic archwires using a cultivation method and PCR: A prospective study. Orthod Craniofac Res 22: 354-360. https://doi.org/10.1111/ocr.12335\u003c/li\u003e\n\u003cli\u003eELdriny AM, Ibrahim SA, Abdel Samad FA, Ali HA (2020) Evaluation of the ddhesion of \u003cem\u003eStreptococcus mutans\u003c/em\u003e to different orthodontic arch wires and the effect of honey mouth wash on it. Al-Azhar Dent J Girls 7: 643-648. https://doi.org/10.21608/adjg.2020.17843.1198\u003c/li\u003e\n\u003cli\u003ePolke P, Jain U, Marothiya S, Agrawal P, Dixit S, et al. (2021) Comparative evaluation of biofilm adhesion to different types of archwire and microbiological colonization during orthodontic treatment. J Indian Orthod Soc 55: 150-157. https://doi.org/10.1177/0301574220957794\u003c/li\u003e\n\u003cli\u003eLaird C, Xu X, Yu Q, Armbruster P, Ballard R (2021) Nickel and chromium ion release from coated and uncoated orthodontic archwires under different pH levels and exposure times. J Oral Biosci 63: 450-454. https://doi.org/10.1016/j.job.2021.10.007\u003c/li\u003e\n\u003cli\u003eArab S, Malekshah SN, Mehrizi EA, Khanghah AE, Naseh R, et al. (2016) Effect of fixed orthodontic treatment on salivary\u003cspan dir=\"RTL\"\u003e \u003c/span\u003eflow, pH and microbial count. J Dent (Tehran) 13: 18\u003cspan dir=\"RTL\"\u003e. \u003c/span\u003e\u003c/li\u003e\n\u003cli\u003eAhn S-J, Kho H-S, Lee S-W, Nahm D-S (2002) Roles of salivary proteins in the adherence of oral streptococci to various orthodontic brackets. J Dent Res 81: 411-415. https://doi.org/10.1177/1544059\u003cspan dir=\"RTL\"\u003e10208100611\u003c/span\u003e\u003c/li\u003e\n\u003cli\u003eFatani EJ, Almutairi HH, Alharbi AO, Alnakhli YO, Divakar DD, et al. (2017) In vitro assessment of stainless steel orthodontic brackets coated with titanium oxide mixed Ag for anti-adherent and antibacterial properties against \u003cem\u003eStreptococcus mutans \u003c/em\u003eand\u003cem\u003e Porphyromonas gingivalis\u003c/em\u003e. Microb \u003c/li\u003e\n\u003c/ol\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Acidic saliva, Orthodontic treatment, Orthodontic wires, Streptococcus mutans","lastPublishedDoi":"10.21203/rs.3.rs-6058536/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6058536/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjectives:\u003c/strong\u003e This study investigates the adhesion of \u003cem\u003eStreptococcus mutans\u003c/em\u003e\u003cem\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/em\u003eto fixed orthodontic wires in varying types of saliva under laboratory conditions, given the heightened microbial load and increased caries prevalence in patients with orthodontic appliances.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods and Materials\u003c/strong\u003e: Stainless steel wires and nickel-titanium wires of the same dimensions were utilized, with six samples per group. After preparation and sterilization, the samples were immersed for two hours in artificial saliva solutions with either normal or acidic pH. Subsequently, the samples were incubated in a \u003cem\u003eS. mutans\u003c/em\u003esuspension. Following serial dilution and cultivation on BHI agar, the number of former colonies was counted. The results were analyzed using two-way ANOVA with a significance level at \u003cem\u003ep\u003c/em\u003e ≤ 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The adhesion rate of \u003cem\u003eS. mutans\u003c/em\u003e to stainless steel archwires was significantly higher than that to nickel-titanium archwires in both acidic and normal saliva (\u003cem\u003ep\u003c/em\u003e ≤ 0.05). Moreover, the adhesion rate to both archwires was lower in acidic saliva compared to normal saliva (\u003cem\u003ep\u003c/em\u003e ≤ 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e \u003cem\u003eS. mutans\u003c/em\u003e exhibits a lower adhesion rate to nickel-titanium archwires compared to stainless steel archwires in both acidic and normal saliva.\u003c/p\u003e","manuscriptTitle":"Comparison of Streptococcus mutans adhesion to fixed orthodontic wires in different types of saliva under laboratory conditions","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-21 13:48:06","doi":"10.21203/rs.3.rs-6058536/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"64681f44-b8fd-443d-9186-305f2c36f2a6","owner":[],"postedDate":"February 21st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-03-01T17:23:30+00:00","versionOfRecord":[],"versionCreatedAt":"2025-02-21 13:48:06","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6058536","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6058536","identity":"rs-6058536","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}