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Orthodontic therapy is becoming a mainstay for the correction of esthetic and functional disturbances in both young and older adults. Orthodontic forces act on the periodontium and can have wide-ranging effects, from beneficial to harmful, from being a hindrance to oral hygiene maintenance to causing irreversible periodontal breakdown. In some patients, the presence of periodontal conditions like gingival recession, before start of orthodontic therapy, raises many questions. Much controversy and confusion exist regarding the need for periodontal therapy, its sequencing, especially in case of recession in a young patient who needs orthodontic therapy. An interactive, interdisciplinary approach is essential in such cases for success. This case report illustrates the interdisciplinary management of a young patient with gingival recession with an eight-year follow-up of the case.

Objective: To quantify the adherence of Streptococcus mutans and Candida albicans on brackets made of stainless steel, plastic, ceramic, titanium, and gold, and to evaluate the various sites of adherence of these microorganisms with scanning electron microscopy (SEM). Materials and Methods: Brackets made of stainless steel, plastic, ceramic, titanium, and gold were used. The adherence of S. mutans and C. albicans were studied. The brackets were placed in flat-bottomed vials containing basal medium with 20% sucrose added; the flasks were inoculated with each of the microbial suspensions. The samples were incubated at 37°C for 48 h, after which the brackets were removed. The cells adhering to the glass were counted and the brackets were studied with SEM. Results: When evaluated together, the adherence of S. mutans and C. albicans was increased in the ceramic bracket group. When evaluated separately, metallic brackets had increased number of colony-forming units (CFUs) of S. mutans and the use of titanium brackets increased the CFUs of C. albicans. SEM demonstrated that the adherence of S. mutans and C. albicans together varied according to the bracket materials, with ceramic having the greatest and stainless steel having the least adherence. Conclusions: Oral hygiene may be of greater concern with esthetic brackets since this study shows that microbial adhesion is greater with these brackets. [ABSTRACT FROM AUTHOR]