Takane VV, Jatti R, Bhat K, Keshan D, Keluskar K, et al. (2018) Microbiological Evaluation of Biofilm Formation on the Fixed Twin Block Appliance: A Clinical Trial. Int J Oral Dent Health 4:066.


© 2018 Takane VV, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

RESEARCH ARTICLE | OPEN ACCESSDOI: 10.23937/2469-5734/1510066

Microbiological Evaluation of Biofilm Formation on the Fixed Twin Block Appliance: A Clinical Trial

Vanashree Vilas Takane1*, Roopa Jatti2, Kishore Bhat3, Divya Keshan4, Kanhoba Keluskar5 and Amit Jaisinghani6

1Private Practitioner, Smilekart Dental Clinic, India

2Head of Department, K.L.E.V.K.I.D.S, JNMC Campus, India

3Professor, Department of Microbiology, Maratha Mandal Dental College, India

4Private Practitioner, K.L.E.V.K.I.D.S, JNMC Campus, India

5Dean, K.L.E.V.K.I.D.S, JNMC Campus, India

6Lecturer, Sinhgad Dental College and Hospital, India



Fixed twin block-a fixed functional appliance, used in orthodontic therapy serves as a surface for microbial colonisation. The microorganisms organised as biofilms are protected from harmful environmental factors and an increased risk of disease may be its direct consequence.

Study design

Fixed Twin Block appliances of 21 healthy children among the ages of 11 to 15 years were taken to evaluate the different types of microorganisms associated with biofilm formation on this functional appliance at baseline, 1st, 3rdmonth and 6thmonths. For isolation of microorganism from biofilms different types of selective and nonselective medium based on standard methods were used. The percentage frequencies of isolates were also calculated.


Gram positive cocci- S. mutans, S. mitisand other Streptococcus sp., Gram-negative Facultative anaerobic rods of Enterobacteriaceae sp. like Enterobacter faecalis, Klebsiella pneumoniae, Escherichia coli, proteus, citrobactor; Obligate anaerobic rods- Porphyromonas gingivalisand Prevotella intermedia, Gram positive facultative anaerobic rods like lactobacilliand actinomyces; and Candida albicanswere found in the samples. Statistically significant elevated levels of S. mutans, S. mitis, other streptococci, Actinomyces spp, Candida sp., E. coliwith increase in time show peak values at six months except for S. mitisand other streptococci sp.


The employment of fixed acrylic based Twin Block appliance can represent a factor promoting the colonisation of the oral cavity by various micro-organisms and stresses the need of a careful monitoring of orthodontic patients for the risk of development of various plaque associated diseases and institution of preventive measures for the same.