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Updated: Jun 2, 2026
Oral Biofilm Formation on Different Materials for Dental Implants
Published on: June 24, 2018
Comparative analysis of long-term biofilm formation on metal and ceramic brackets
Ira Dewi Lindel1, Cornelius Elter, Wieland Heuer
1Department of Orthodontics, Hannover Medical School, Hannover, Germany.
Objective:
To test the null hypothesis that stainless steel and ceramic brackets show no differences in biofilm adhesion.
Materials And Methods:
Twenty adolescents (6 boys, 14 girls) who had received fixed orthodontic therapy for 18.9 ± 3.2 months were divided into a metal and a ceramic bracket group. Thirty brackets per group were taken from central incisors, canines, and second premolars and quantitatively analyzed for biofilm coverage with the Rutherford backscattering detection method. Five micrographs were obtained per bracket with views from the buccal, mesial, distal, gingival, and occlusal aspects, resulting in a total of 300 images. Biofilm formation between groups was compared using the Mann-Whitney U-test (α = .05).
Results:
Total biofilm formation was 12.5% ± 5.7% (3.3 ± 1.6 mm(2)) of the surface on metal and 5.6% ± 2.4% (1.5 ± 0.6 mm(2)) on ceramic brackets. Differences between groups were statistically significant (P < .05). A pairwise comparison of biofilm formation revealed significantly lower biofilm formation on ceramic brackets with respect to intraoral location (central incisor, canine, second premolar) and bracket surface (buccal, mesial, distal).
Conclusions:
The hypothesis was rejected. The results indicate that ceramic brackets exhibit less long-term biofilm accumulation than metal brackets.
