Original Article

Int J Clin Prev Dent 2016;12(2):81-90http://dx.doi.org/10.15236/ijcpd.2016.12.2.81

ISSN (Print) 1738-8546ISSN (Online) 2287-6197

The Effect of Cleanser Containing Persulfate Compounds

and Sodium Perborate Monohydrate on Orthodontic
Appliances
Kyung-Sook Hwang1, Yong-Jun Choi2, Jung-Eun Park2, Jung-Hee Yoo3, Soo-Min Yoo4,
5
6
7
Jong-Hwa Jang , Jung-Hyun Kim , Jin-Young Park
1

Department of Dental Technology, Shin Han University, Uijeongbu, 2Department of Preventive and Social Dentistry, School of
3
4
Dentistry, Kyung Hee University, Seoul, MEDITIP Co. Ltd., Seoul, Department of Dental Hygiene, Kyungdong University,
5
6
Wonju, Department of Dental Hygiene Science, Hanseo University, Seosan, Chemical & Biomolecular Engineering, KAIST,
7
Department of Dental Hygiene Science, Shinsung University, Dangjin, Korea

Objective: Patients are instructed to remove their braces/retainers and to clean them using toothbrushes or cleaning solutions
before sleeping. However, many patients find this process inconvenient, and do not regularly clean their appliances.
Methods: Past study tests the cleaning ability of a liquid cleansing method (as opposed to using brushes). Fittydent Mega
Cleansing Tablets wereused on various orthodontic appliances (acrylic resin) to test the their cleansing power. The plaque
cleaning ability of liquid containing persulfate compound and sodium perborate monohydrate was tested onplaque-applied
orthodontic appliances (used in dental clinicaltrials). cleansing (5 days), followed by the second inspectionrepeatedplaque
coating and cleansing (5 days), followed by the third inspectionsafety and efficacy analysis.
Results: In case of cleaning braces/retainers using cleansing tablet including persulfate compound and sodium perborate
monohydrate, immersingthe appliance for 5 minutes in 200 ml water containing 1 tablet before sleeping can have a definite
bacteriostasis effect of cleaning off the plaque.
Conclusion: We obtain a sufficient result, such as the safety, the plaque inhibitory effect of the color or intensity to the
laboratory. Accordingly Fittydent Mega Cleansing Tablets as a calibration device dent pills are deemed worthy enough asoral
supplements.
Keywords: orthodontic appliances, persulfate, sodium perborate monohydrate

Introduction

Corresponding author Jin-Young Park

Department of Dental Hygiene Science, Shinsung University,
1 Daehak-ro, Jeongmi-myeon, Dangjin 31801, Korea. Tel:
+82-41-961-0344, Fax: +82-41-567-2008, E-mail:
dreamof82@hanmail.net

With rapid urbanization in the 1980s, the Korean society has

become more nuclear family-oriented. By 1990s, the birthrate
fell below 1.5. The International Monetary Fund crisis caused
the birthrate to fall below the 0.5 line during the early 2000s,
turning Korea into a country with one of the lowest-birthrates
in the world. With this social change, national attention shifted
to children. Larger cities began to focus more on childrens edu-

Received April 9, 2016, Revised May 3, 2016,

Accepted May 3, 2016

Copyright 2016. Korean Academy of Preventive Dentistry. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/
by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

81

International Journal of Clinical Preventive Dentistry

cation and medical treatment, the latter of which included orthodontic treatment [1-4]. According to a nation-wide study of dental health conducted in 2015, 6% of elementary school students
in large cities wear orthodontic appliances. In small-to-middle
sized cities, this rate was 3.5%. Such appliances must stay in
the patients mouth for at least 12 hours a day. In some cases,
patients wear permanent retainers for post-treatment
maintenance. The base of a dental retainer is acrylic resin, which
is reinforced with thin metal wires to allow stable long term use.
Dental braces and retainers have several similarities and differences with dentures. Both orthodontic appliances and dentures
are made to fit the unique shapes of patients dental structures.
Both minimize the exposure of the metal wire using resin. The
key difference is that dentures are usually thicker to serve their
functional purpose [5]. Orthodontic appliances, on the other
hand, are made thinner because they simply serve to keep the
teeth in their correct places. Their end purpose is aesthetics, so
they are made with clear resin; this is another difference between orthodontic appliances and dentures. However, like dentures, orthodontic appliances stay in the patients mouths for
long periods of time, and also require regular cleaning and
maintenance. Plaque forms in both soft and hard tissues to cause
dental caries. Considering this, it can be argued that dental braces and retainers provide media for micro-organism growth.
This study has been planned to research appropriate plaque control methods for braces and retainers.
Generally, patients are instructed to remove their braces/retainers and to clean them using toothbrushes or cleaning solutions before sleeping [5,6]. However, many patients find this
process inconvenient, and do not regularly clean their appliances. Orthodontic appliances usually consist of resin parts and
wire parts. While it is difficult for plaque to form at the thin wire
component, a proper cleaning method should be studied for the
acryl resin component [7,8]. Orthodontic appliances can be
largely divided into braces for treatment and retainers for maintaining the proper shape. The latter can further be classified into
palate-covering types and open-palate types. Plaque prevention on acryl parts was tested based on these three types of
appliances picture. Based on 2009 study by Dullea et al. [5], this
study tests the cleaning ability of a liquid cleansing method (as
opposed to using brushes). Fittydent Mega Cleansing Tablets
(Fittydent International, Pinkafeld, Austria) were used on various orthodontic appliances (acrylic resin) to test the their
cleansing power [1].

Materials and Methods

The plaque cleaning ability of liquid containing persulfate
compound and sodium perborate monohydrate was tested on

82 Vol. 12, No. 2, June 2016

plaque-applied orthodontic appliances (used in dental clinical

trials) [1]. Reduction of micro-organisms found in oral environment was also tested. In order to conduct the test, identical retainers were needed. These retainers had to be applied with plaque similar to the kind that forms on patients teeth. Additionally, approval from institutional review board (KHD IRB
1408-2) had to be obtained in order to clinically test the cleansers ability to prevent the growth of oral micro-organisms. The
overall test process was as follows: preparing the appliances (15
days)repeated plaque coating and cleansing (5 days), followed by the first inspectionrepeated plaque coating and
cleansing (5 days), followed by the second inspectionrepeated plaque coating and cleansing (5 days), followed by the
third inspectionsafety and efficacy analysis.

1. Cleanser ingredients
Acting as components of the laboratory detergents used in
this study is shown in Table 1.

2. Types of orthodontic appliances

1) Treatment brace
Single-body brace that can be worn at the upper and the lower
jaws simultaneously during the orthodontic treatment period.
The brace consists of a main resin body with metal wires supporting certain parts.
2) Retainers
Retainers are used after the orthodontic treatment to prevent
the teeth from reverting to their original positions. Retainers
may be needed temporarily or permanently. As shown in the
Figure 1, retainers come in two types: palate-covering (Figure
1B) and open-palate (Figure 1C).
These classifications were based not on academic reasons,
but on external factors for the facilitation of the study. These apTable 1. Action and research components of the detergent
Ingredient
Sodium bicarbonate
Oxone (potassium
monopersulfate)
Sodium perborate
monohydrate
Citric acid
Sodium lauryl sulfate
Mint flavoring
Food blue No. 1
q.s: quantum sufficit.

Purpose

Contained amount
(2,166 mg/1 tablet)

Main ingredient
Main ingredient

Main ingredient

Bubbling
Surface active
ingredient
Fragrance ingredient
Coloring ingredient

25 mg
15 mg
5 mg
q.s

Kyung-Sook Hwang, et alOrthodontic Appliances Cleanser

Figure 1. Types of orthodontic appliances. (A) Single-body type. (B) Plate-covering type. (C) Open-palate type.
Table 2. Test and control groups, based on presence of persulfate compound and sodium perborate monohydrate
Control set (15 pieces)

Test set (15 pieces)

C-a

C-b

C-c

T-a

T-b

T-c

Braces

Retainer, palate-covering

Retainer, open-palate

Braces

Retainer, palate-covering

Retainer, open-palate

All made 5 each per group in acrylic material (C-a, C-b, C-c, T-a, T-b, and T-c group).

pliances all consist of acrylic resin as their main components.

The metal parts are mostly covered by the resin body to prevent
air contact, with only thin wires protruding outside. It is very
unlikely for plaque to form on these thin wires, and it is impossible to analyze any plaque on these surfaces.

3. Preparing the appliances

The appliances were created by a dental technician specializing in dental products. A. A control set of 15 pieces (consisting
of 1 type of acryl brace [Figure 1A] and 2 types of retainers
[Figure 1B, 1C]) was prepared to be used with a cleanser without
persulfate compound and sodium perborate monohydrate. B.
A test set of 15 pieces (consisting of 1 type of acryl brace [Figure
1A] and 2 types of retainers [Figure 1B, 1C]) was prepared to
be tested with a cleanser containing persulfate compound and
sodium perborate monohydrate. Thirty pieces were prepared in
total. The following Table 2 shows the organization of each
group. Therefore, the distribution groups are shown in Table 2.

4. Test material and method

1) In vitro plaque growth and denture staining
This test was double blind. The cleansers for the test group
and the control group were prepared by the principal investigator. The laboratory staff cleaned each group according to the
principal investigators instructions, but remained blind as to
the identity of the groups.

2) Plaque coating
(1) Plaque cultivation: A 150 g Todd Hewitt broth (dried) and
50 g saccharose were dissolved in 5 L deionized water. Widemouth Erlenmeyer flasks (10-12,500 ml) were filled with 400
ml of the broth, and sealed with polyurethane foam stoppers.
The flask stoppers were covered with aluminum foil. The broths
were placed in an autoclave at 121oC, 15 psi for 15 minutes. The
o
broths were then cooled to 40 C. Human saliva (2 ml) was added
to each flask containing the broth (microcrystalline wax was
used to stimulate saliva secretion) [1]. Each flask was gently
swirled to guarantee even distribution of saliva. The broth samples were applied to the sterilized orthodontic appliances. The
prepared appliances were then covered and left to cultivate for
o
18 hours at 37 C. After cultivation, each appliance was removed
using forceps. Each appliance was gently washed in a beaker
with deionized water (to remove any remaining broth from the
surface). The appliances were dried for 1 hour on paper towel,
o
and were treated in an oven for 45 minutes at 37 C. Samples with
uneven distribution of plaque were discarded. A sample appliance for cleansing test must have an even distribution of plaque
on its resin component.
(2) Staining of the cultivated plaque
Preparation of the staining solution: A. Blueberry solution
was prepared by mixing 150 g blueberry pie filling (Comstock
brand, My Brands, NY, USA) and 150 mL deionized water using
electric blender (1 minute). B. Instant coffee (10 g) was added
to 250 ml deionized water and was allowed to dissolve for 5
minutes. C. Deionized water (500 ml) was heated to 100oC. Two
www.ijcpd.org

83

International Journal of Clinical Preventive Dentistry

tea bags were added and were allowed to diffuse for 10 minutes.
The solution was then cooled to room temperature. D. Merlot
wine (250 ml) was prepared. E. Each of the abovementioned
staining solutions (250 g) (blueberry, coffee, tea, and wine) was
mixed together in a beaker for 5 minutes.
Sample preparation: A. Acceptable samples with even
plaque coating were chosen. Forty samples were numbered on
the back side. Five plaque coated samples of each type were
placed on each of four autoclave trays. B. Approximately 1,000
ml of mixed staining solution was poured in each tray containing the samples. C. The trays were closed and left to sit for 18
hours. D. The stained samples were removed from the tray and
placed on absorbent paper towels. The samples were left to dry
o
for approximately one hour, and then placed in an oven at 37 C
for 45 minutes. Afterwards the samples were removed and allowed to cool to room temperature. E. The samples were visually inspected. Those with uneven distribution of stain were
discarded.
(3) Disclosing solution: Coloring solution used to determine
the plaque levels of the samples was Sultan (Sultan Medical,
Hackensack, NJ, USA).
3) Staff training
The study staffs were instructed to ensure that both types of
cleaning solutions were used for each group for daily plaque
buildup and routine plaque level measurement [1]. The staffs
were also instructed to ensure precise cleansing time and plaque
build up time for each process. To ensure consistency, the
amount of cleaning solution used per cleanse was set to 200 ml.
Each appliance sample was immersed in the cleansing solution
for 5 minutes. Then, the sample was removed and washed using
flowing water. The specific time for this daily process was 6:00
PM to 6:05 PM (5 minutes). The process was repeated for five
consecutive days. In order to perform this study as a double-blind study, the dissolving amount for both groups (test and
control) followed the instruction provided by the manufacturer

(1 tablet dissolved in 200 ml solution). Only the principal investigator was informed of the different cleansing solutions of the
two groups, and the staffs were left blind for the duration of the
study for accurate plaque measurement.

5. Anti-oral micro-organism test

Generally, over 70% of plaque consists of more than 350 different species of oral micro-organisms [1]. The plaque removal
effect of the cleanser could be tested in vitro from repeated studies, but in order to confirm the results objectively, cleaned appliances were installed in the participants mouths for 4 hours, and
were tested for oral micro-organism growth level. For each sample, plaque was collected from the palate portion of the appliance, which has the largest contact area with the wearers
mouth. For this purpose, 10 test participants who were using actual orthodontic appliances were gathered. Plaque samples
were collected in order to track three particular species of oral
micro-organisms: Porphyromonas gingivalis, Prevotella intermedia (which are known to cause gingivitis and periodontal
disesase), and Streptococcus mutans (known to cause dental caries) (Figure 2). To carry out the collection process, sterilized,
identical (# 25) paper points were rubbed on the appliances for
10 seconds. Then, the samples were immersed in dental cleaning solution and were placed in containers. These were sent to
a separate gene testing institute (CytoGen Inc., Seoul, Korea)
for testing. This clinical process had undergone a pre-test review by Kyung Hee University Dental Hospital IRB (KHD IRB
1408-2).
1) P. gingivalis
P. gingivalis is a Gram-negative, anaerobic species of bacteria related to periodontal diseases and gingivitis. This species
can communicate with other subgingival bacterial species, and
can cause changes in toxicity and pathogenicity of other disease-causing bacteria.

Figure 2. Oral micro-organisms. (A) Porphyromonas gingivalis, (B) Prevotella intermedia, (C) Streptococcus mutans.

84 Vol. 12, No. 2, June 2016

Kyung-Sook Hwang, et alOrthodontic Appliances Cleanser

2) P. intermedia
P. intermedia is a Gram-negative, anaerobic bacillus, and is
a known cause of periodontal diseases. P. intermedia is frequently found in the subgingival region of patients with periodontitis, acute necrotizing ulcerative gingivitis, and HIV-related gingivitis. As a known cause of periodontal diseases, P.
intermedia invades epithelial cells and produces endotoxin and
other toxic byproducts.
3) S. mutans
S. mutans is a facultative anaerobic bacterial species found
on dental surfaces. These bacteria metabolize sugar to produce
acidic byproduct that can wear out the enamel coating of human
teeth, causing dental caries.

6. Measurement and data analysis

After the plaque coating (18 hours of plaque cultivation and
18 hours of staining), use the plaque disclosing solution to color
and measure the level of plaque. Only the samples with 5 plaque
index were used for the test. The selected samples were placed
into either the control group or the test group, so that each group
had 5 samples. After coating the selected samples with plaque
(1.5 hours of plaque cultivation and 1.5 hours of staining), the
samples were immersed in the respective cleansing solutions
(by group). Both the control group and the test group were immersed at the same time to minimize the difference in variables
between the two groups. The plaque coating (cultivation and
staining) and cleansing process was repeated for 5 consecutive
days. Afterwards, the plaque index, brightness, and hardness of
the acryl resin parts were analyzed. The coating and cleansing
process was repeated again for 5 consecutive days for the second
measurement, after which any residual disclosing solution was
removed using standardized toothbrushes. The coating and

cleansing process was repeated again for 5 consecutive days for

the third measurement. The results from day 10 and day 15 were
taken as the 2nd and 3rd measurement values, respectively. The
values were statistically analyzed along with the first measurement values (SPSS ver. 12.0; SPSS Inc., Chicago, IL, USA).

7. Investigational measurement items

1) Cleansing effect
The samples from the two groups (control and test) were colored using the disclosing solutions for plaque index comparison. According to the Turesky modification of the QuigleyHein plaque index, the index was calculated based on the residual surface amount on the acryl part after staining (with disclosing solution) (Figure 3).
0: No plaque
1: Flecks of plaque on the resin surface
2: Thin band(s) of plaque on the resin surface
3: Plaque covering <1/3 of the resin surface
4: Plaque covering <2/3 of the resin surface
5: Plaque covering >2/3 of the resin surface
2) Safety evaluation
Key safety factors of cleansers for orthodontic appliances
can include: any changes of the appliance directly caused by the
testing process, any changes in the mouth of the participant, and
any overall body effect. This test is in-vitro; therefore only the
color changes of the sample appliances were evaluated. For this
purpose, a dental colorimeter (VITA-Shadeguide-EX, Kyoto,
Japan) was used (Figure 4). Any wear on the surface of the appliance is unrelated to the use of the cleansers, and is thus excluded
from the safety range.
Additionally, repeated immersion process can cause changes
in the hardness of a solid sample appliance. The chemical/phys-

Figure 3. Orthodontic appliance sample test progress (groupingstainingcleansingpre-measurement).

www.ijcpd.org

85

International Journal of Clinical Preventive Dentistry

ical actions of the cleanser and/or other solutions can affect a

samples on the molecular level to change its hardness.
Therefore, the safety factor regarding the hardness of an orthodontic appliance was added to the test. Generally, MicroVickers hardness tester (MVK-H1; Mitutoyo Co., Kawasaki,
Japan) was used to measure the hardness values of the samples.
Pressure was applied with a diamond indenter. The minimum
2
value (kg/mm ) at which a pressure mark was observed served
as the VHN standard to evaluate the hardness quantitatively and
qualitatively.
3) Evaluation of antioral micro-organisms (3 species)
Instead of directly cultivating the oral micro-organisms, the
process of using reverse transcription polymerase chain reaction to evaluate the level of micro-organisms by analyzing the
amount of their DNA was done at a gene testing institute
(CytoGen Inc.). The analysis data was used to evaluate the effectiveness of the cleansers of antioral micro-organisms.

8. Statistic analysis
The average analysis was performed for the 1st, 2nd, and 3rd
measurement results of the two studied items of all test samples.
MANOVA analysis was used to compare the difference between the two groups. For micro-organisms, to compare the ef-

fectiveness of the cleanser before and after the usage, significance test was done as paired t-test.

Results
1. Change in plaque index
For the validity of the plaque index, both groups underwent
the same plaque forming process on the same testing bench. All
samples had the index of 5 (the maximum index), which indicates that plaque coated the entire surface of the sample. At
this point the samples were divided into two groups (control and
test). The samples were immersed in their respective cleansing
solutions for 5 days, after which the changes in their plaque index values were studied. Total of 3 measurements were performed with 5 days for each process.
According to the plaque change results for the acryl surfaces,
the test group which used Fittydent Mega Cleansing Tablets
showed much better plaque removal results compared to the
control group. This was also shown as a statistically significant
result (Table 3). Plaque decreasing effects of A, B, and C test
group contrast to control are 239%, 327%, and 579%, respectively.

Figure 4. Measurement equipment and processes for hardness and coloration.

Table 3. Plaque index results of the test groups and the control groups
Acrylic resin
Single-body brace
Palate-covering retainer
Open-palate retainer

1st exam
Control
Test
Control
Test
Control
Test

2nd exam
a

4.211.10
b
1.940.56
a
4.091.25
b
1.150.36
a
3.980.90
b
0.880.12

3rd exam
a

4.191.18
b
1.640.48
4.881.29a
1.030.44b
4.021.32a
0.740.20b

4.071.28
b
1.630.75
4.320.98a
1.320.61b
3.881.01a
0.670.31b

Average

p-value*

4.16
1.74
4.43
1.17
3.96
0.76

0.009
0.006
0.000

Values are presented as meanstandard deviation. The same letter (a, b) indicates no significant different at =0.01. *p-value by MANOA.

86 Vol. 12, No. 2, June 2016

Kyung-Sook Hwang, et alOrthodontic Appliances Cleanser

within or between the two groups. (p=0.843) (Table 4).

2. Brightness of the acryl component

A colorimeter (VITA-Shadeye-EX) is a device that can check
the original color of teeth or resin. In order to evaluate the color
changes of the prepared orthodontic appliances after plaque
coating and cleansing, all samples were cleaned with their respective cleansing solutions. Afterward, their brightness was
evaluated.
For this process, because the evaluation was for the brightness of the identical acryl components, the type of the appliance
was unimportant. The average of each group was calculated
based on all fifteen samples. The brightness change result for
the samples over three exams showed no statistical difference
Table 4. Brightness change of the acryl components of the test and
control groups
Acrylic resin
group
Control
Test

1st exam

2nd exam

3rd exam

p-value*

3.641.39
3.521.49

3.691.35
3.591.41

3.671.38
3.551.62

0.843

Values are presented as meanstandard deviation. All data indicate no

significant different at =0.01. *p-value by MANOA.

Table 5. Hardness change of the acryl components of the test and

control groups (unit: VHN)
Acrylic resin
group
Control
Test

1st exam

2nd exam

3rd exam

p-value*

258.936.5
263.132.9

262.534.2
265.731.7

260.931.1
264.43.38

0.864

Values are presented as meanstandard deviation. All data indicate no

significant different at =0.01. *p-value by MANOA.

3. Hardness of the acryl component

During the cleansing process of an orthodontic appliance, repeated interaction between the appliance and the solution may
cause the hardness of the appliance to decrease. Therefore, in
addition to discoloration, microscopic-level hardness of the
samples were evaluated in order to ensure the safety of the molecular structure. Thus, if there are existing artificial acrylic resin materials in a patients mouth, any oral implantation should
be made of softer or similar material. Similar to the brightness
test, because the hardness evaluation is for identical acrylic
components, the type of the appliance was unimportant. For
each group, the average was calculated for all 15 samples.
The VHN of the acrylic component is between 258.9 to 265.7,
which is lower than theaverage VHN of natural teeth (356).
The result values over 3 exams showed no statistical difference
within and between the two groups (p=0.864) (Table 5).

4. Eliminating effect of oral micro-organisms

Table 6, 7 show the results of measuring the level of growth
of the three bacterial species on the sample appliances, which
had been cleaned with respective cleansing solutions for each
group and then worn by the participants for four hours.
The control group showed a statistically significant difference (p<0.001) between the baseline measured immediately after cleaning and the level after four hours. The growth percentages of the oral micro-organisms during the four-hour period
for the control group were: P. gingivalis 51.8%, P. intermedia
117.13%, and S. mutans 1,104% (Figure 5). For the test group,
the growth percentages were 25.19%, 1.46%, and 34.70%,
respectively. For each bacterial species, the test cleansing sol-

Table 6. Pre-/post-test bacterial removal effect: control group

Baseline (B) (immediately after cleaning)

After (A) 4 hours (of wearing the sample)
a
1

Porphyromonas gingivalis

Prevotella intermedia

Streptococcus mutans

45,82649,131
69,56447,526
51.8

113,180322,328
245,746753,947
117.13

11,44464,225
137,793547,733
1,104.06

a
Values are presented as meanstandard deviation or percentage only. Increase rate after 4 hours from the baseline (BA)/B100.

Table 7. Pre-/post-test bacterial growth repressing effect: test group

Baseline (B) (immediately after cleaning)

After (A) 4 hours (of wearing the sample)
a
2
12

Porphyromonas gingivalis

Prevotella intermedia

Streptococcus mutans

56,676287,539
70,956159,948
25.19
26.61

699,7431,541,437
793,9441,691,232
13.46
103.67

59,371214,974
79,974392,412
34.70
1,069.36

a
Values are presented as meanstandard deviation or percentage only. Increase rate after 4 hours from the baseline (BA)/B100.

www.ijcpd.org

87

International Journal of Clinical Preventive Dentistry

sulfate compound and sodium perborate monohydrate, immersing the appliance for 5 minutes in 200 ml water containing
1 tablet before sleeping can have a definite bacteriostasis effect
of cleaning off the plaque [21,22].

Conclusion

Figure 5. Inter-group difference in bacterial growth-repressing

effect. 1: increase rate of the control group from the baseline, 2:
increase rate of the test group from the baseline,

ution containing persulfate compound and sodium perborate

monohydrate showed 26.61% (P. gingivalis), 103.67% (P. intermedia), and 1,069.36% (S. mutans) growth-repressing effect
over the control solution. The result showed a statistical difference between the two groups (p<0.001) (Table 7).

Discussion
Approximately 75% of dental plaque is composed of
bacteria. There are two ways to remove these bacteria [1,9,10].
The first method is to kill them via such methods as sterilization,
bacteriocidal actions, and bacteriostasis. The second method is
to wash them off. Orthodontic appliances stay in the mouths of
the patients during the day time, and the accumulated bacteria
(plaque) must be cleaned off during the night time. Orthodontic
appliances cannot stand the 121oC, 15 psi condition of mechanical sterilization machine [11,12]. Therefore, cleansing solution is necessary in order to maintain the safety of such appliances and remove the plaque buildup [13,14]. The downside of
such cleansing solution is that it can stain the users teeth,
tongue, or the appliance itself [15-17]. Continued long-term use
of such cleansing solutions can cause accumulation of stain and
changes in the hardness of the appliance.
However, as apparent from the thrice repeated test results
from this study, the group cleaned with cleansing tablet including persulfate compound and sodium perborate monohydrate
showed excellent plaque-removal results from their acrylic resin components. In addition, even after continued use, the test
group samples maintained both their original brightness and
hardness levels [18-20].
Therefore, according to the results of this study, in case of
cleaning braces/retainers using cleansing tablet including per-

88 Vol. 12, No. 2, June 2016

This study tests the cleaning ability of a liquid cleansing

method. Fittydent Mega Cleansing Tablets were used on various orthodontic appliances to test the their cleansing power. The
experimental results, we obtain a sufficient result, such as the
safety, the plaque inhibitory effect of the color or intensity to
the laboratory. Accordingly Fittydent Mega Cleansing Tablets
as a calibration device dent pills are deemed worthy enough as
oral supplements.

Acknowledgements
This research was supported by Basic Science Research
Program through the National Research Foundation of Korea
(NRF) funded by the Ministry of Science, ICT & Future
Planning (NRF-2014R1A1A3051084).

References
1. Kim SJ, Kwon HJ, Kim JE, Park JE, Yoo JH, Park YS, et al. Safety
and efficacy of fittydent mega denture clean agents: in vitro. Int
J Clin Prev Dent 2014;10:147-56.
2. Ministry of Health & Welfare. Korea National Survey (No111460000-000974-12), 2012. Sejong: Ministry of Health &
Welfare; 2012.
3. Kraivaphan P, Amornchat C, Triratana T. Effects of a triclosan
dentifrice on plaque formation, gingivitis and gingival bleeding
in pregnant women: five-month clinical results. Southeast Asian
J Trop Med Public Health 2007;38:594-7.
4. Kim JB, Paik DI, Moon HS, Kim HD, Jin BH, Choi YJ, et al.
Clinical preventive dentistry. Seoul: Komoonsa; 2005:127.
5. Dullea C, OMullane D, Grant D, Biddescomb J, Moroni A,
Marken B. Evaluation of in-vitro combination food stain plaque
model. IADR; 2009 April 1-4; Washington DC, USA.
6. Lai CP, Tsai MH, Chen M, Chang HS, Tay HH. Morphology and
properties of denture acrylic resins cured by microwave energy
and conventional water bath. Dent Mater 2004;20:133-41.
7. Lai YL, Lui HF, Lee SY. In vitro color stability, stain resistance,
and water sorption of four removable gingival flange materials.
J Prosthet Dent 2003;90:293-300.
8. Hersek N, Canay S, Uzun G, Yildiz F. Color stability of denture
base acrylic resins in three food colorants. J Prosthet Dent 1999;
81:375-9.
9. Sesma N, Lagan DC, Morimoto S, Gil C. Effect of denture surface glazing on denture plaque formation. Braz Dent J 2005;16:

Kyung-Sook Hwang, et alOrthodontic Appliances Cleanser

129-34.
10. Kuhar M, Funduk N. Effects of polishing techniques on the surface roughness of acrylic denture base resins. J Prosthet Dent
2005;93:76-85.
11. Koksal T, Dikbas I. Color stability of different denture teeth materials against various staining agents. Dent Mater J 2008;27:
139-44.
12. Paranhos HF, Silva-Lovato CH, de Souza RF, Cruz PC, de
Freitas-Pontes KM, Watanabe E, et al. Effect of three methods
for cleaning dentures on biofilms formed in vitro on acrylic resin.
J Prosthodont 2009;18:427-31.
13. Nalbant AD, Kalkanci A, Filiz B, Kustimur S. Effectiveness of
different cleaning agents against the colonization of Candida spp
and the in vitro detection of the adherence of these yeast cells
to denture acrylic surfaces. Yonsei Med J 2008;49:647-54.
14. Moreira CH, Luz PB, Villarinho EA, Petri LC, Weidlich P,
Rsing CK. A clinical trial testing the efficacy of an ionic toothbrush for reducing plaque and gingivitis. J Clin Dent 2007;18:
123-5.
15. Hong G, Murata H, Li Y, Sadamori S, Hamada T. Influence of
denture cleansers on the color stability of three types of denture
base acrylic resin. J Prosthet Dent 2009;101:205-13.

16. Rodrigues Garcia RC, Joane Augusto de S Jr, Rached RN, Del
Bel Cury AA. Effect of denture cleansers on the surface roughness and hardness of a microwave-cured acrylic resin and dental
alloys. J Prosthodont 2004;13:173-8.
17. Goodson LB, Glass RT, Bullard JW, Conrad RS. A statistical
comparison of denture sanitation using a commercially available denture cleaner with and without microwaving. Gen Dent
2003;51:148-51.
18. Glass RT, Goodson LB, Bullard JW, Conrad RS. Comparison of
the effectiveness of several denture sanitizing systems: a clinical
study. Compend Contin Educ Dent 2001;22:1093-6, 1098,
1100-2 passim; quiz 1108.
19. Drake D, Wells J, Ettinger R. Efficacy of denture cleansing
agents in an in vitro bacteria-yeast colonization model. Int J
Prosthodont 1992;5:214-20.
20. Glass RT, Belodraydic KA. The dilemma of denture contamination. Todays FDA 1991;3:4C-6C.
21. Abelson DC. Denture plaque and denture cleansers. J Prosthet
Dent 1981;45:376-9.
22. Turesky S, Gilmore ND, Glickman I. Reduced plaque formation
by the chloromethyl analogue of victamine C. J Periodontol
1970;41:41-3.

www.ijcpd.org

89