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Am J Orthod Dentofacial Orthop. 2011 May;139(5):e463-70. doi: 10.1016/j.ajodo.2010.05.019.

Plaque levels of patients with fixed orthodontic appliances measured by digital plaque image analysis.

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Senior scientist, Procter and Gamble Company, Mason Business Center, Mason, Ohio, USA.



A digital plaque image analysis system was developed to objectively assess dental plaque formation and coverage in patients treated with fixed orthodontic appliances.


The technique was used to assess plaque levels of 52 patients undergoing treatment with fixed appliances in the Department of Orthodontics at Johannes Gutenberg University in Mainz, Germany.


Plaque levels ranged from 5.1% to 85.3% of the analyzed tooth areas. About 37% of the patients had plaque levels over 50% of the dentition, but only 10% exhibited plaque levels below 15% of tooth coverage. The mean plaque coverage was 41.9% ± 18.8%. Plaque was mostly present along the gum line and around the orthodontic brackets and wires.


The digital plaque image analysis system might provide a convenient quantitative technique to assess oral hygiene in orthodontic patients with multi-bracket appliances. Plaque coverage in orthodontic patients is extremely high and is 2 to 3 times higher than levels observed in high plaque-forming adults without appliances participating in clinical studies of the digital plaque image analysis system. Improved hygiene, chemotherapeutic regimens, and compliance are necessary in these patients.

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