Oxidative Stress Evaluation in Patients Treated with Orthodontic Self-ligating Multibracket Appliances: An in Vivo Case-Control Study

Marco Portelli1, *, Angela Militi1, Gabriele Cervino1, Floriana Lauritano1, Sergio Sambataro2, Alberto Mainardi3, Riccardo Nucera1
1 Department of Biomedical, Dental Science and Morphological and Functional Images, Dental School, University of Messina, Messina, Italy
2 Private Practice, Center Orthodontics and Gnathology (COS), Catania, Italy
3 CIR Dental School of Turin, University of Turin, Turin, Italy

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Creative Commons License
© 2017 Portelli et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Biomedical, Dental Science and Morphological and Functional Images Dental School, Faculty of Medicine, University of Messina, Via Consolare Valeria, Gazzi, C.A.P. 98100 Messina, Italy; Tel: 0039090/2216910; Fax 0039090/2216911; E-mail:



Oxidative stress is a pathologic event induced by a prevalence of oxidant agents on the antioxidant ones, with a consequent alteration of oxide-reducing balance.


Freeradicals produce damages both in cellular and extra-cellular components; phospholipid membranes, proteins, mitochondrial and nuclear DNA, are the target of the oxidative stress, that can finally cause cellular death due to apoptosis.

Materials & Methods:

Orthodontic appliances such as brackets, wires, resins and soldering have some components that can be considered as potential allergen, carcinogenic, cytotoxic and gene mutation factors. The primary aim of this research is to evaluate oxidative stress in the saliva of patients treated with multibracket self-ligating vestibular orthodontic appliances; the secondary purpose is to investigate the influence of orthodontic multibracket therapy on oral hygiene and the consequent effect on oxidative stress. Salivary specimens has been collected in a sample of 23 patients were enrolled (12 Female, 11 Male) between 12 and 16 years of age (mean age 14.2). For each patient has been collected a salivary specimen at the following time points; before orthodontic bonding (T1), five weeks (T2) and ten weeks (T3) after orthodontic appliance bonding.


Samples has been analysed with a photometer due to SAT Test (Salivary Antioxidant Test). Data obtained show a mean of 2971 mEq/l of anti-oxidant agents before orthodontic treatment, and after five weeks from the bonding the mean was decreased to 2909 mEq/l, instead at ten weeks was increased to 3332 mEq/l. Repeated measures ANOVA did not reveal statistically significant differences between the time points (P = 0.1697). The study did not reveal any correlation between the level of dental hygiene and that of oxidative stress (Pearson Correlation Coefficient R = 0).


Orthodontic treatment with multibrackets vestibular metallic appliance seems to be not able to affect oxidative stress during the first ten weeks of therapy.

Keywords: Oxidative stress, Multibrackets orthodontic appliance, Salivary antioxidant test, Extra-cellular components, Apoptosis.