The oral microbiota develops within the first 2 years of childhood and becomes distinct from the parents by 4 years‐of‐age. The oral microbiota plays an important role in the overall health/symbiosis of the individual. Deviations from the state of symbiosis leads to dysbiosis and an increased risk of pathogenicity. Deviations can occur not only from daily life activities but also from orthodontic interventions. Orthodontic appliances are formed from a variety of biomaterials. Once inserted, they serve as a breeding ground for microbial attachment, not only from new surface areas and crevices but also from material physicochemical interactions different than in the symbiotic state. Individuals undergoing orthodontic treatment show, compared with untreated people, qualitative and quantitative differences in activity within the oral microbiota, induced by increased retention of supra‐ and subgingival microbial plaque throughout the treatment period. These changes are at the root of the main undesirable effects, such as gingivitis, white spot lesions (WSL), and more severe caries lesions. Notably, the oral microbiota profile in the first weeks of orthodontic intervention might be a valuable indicator to predict and identify higher‐risk individuals with respect to periodontal health and caries risk within an otherwise healthy population. Antimicrobial coatings have been used to dissuade microbes from adhering to the biomaterial; however, they disrupt the host microbiota, and several bacterial strains have become resistant. Smart biomaterials that can reduce the antimicrobial load preventing microbial adhesion to orthodontic appliances have shown promising results, but their complexity has kept many solutions from reaching the clinic. 3D printing technology provides opportunities for complex chemical syntheses to be performed uniformly, reducing the cost of producing smart biomaterials giving hope that they may reach the clinic in the near future. The purpose of this review is to emphasize the importance of the oral microbiota during orthodontic therapy and to use innovative technologies to better maintain its healthy balance during surgical procedures.

中文翻译：

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正畸患者的口腔微生物群和牙周健康


口腔微生物群在儿童期的头 2 年内发育，并在 4 岁时与父母的微生物区分开来。口腔微生物群在个体的整体健康/共生中发挥着重要作用。偏离共生状态会导致生态失调和致病风险增加。偏差不仅可能来自日常生活活动，也可能来自正畸干预。正畸矫治器由多种生物材料制成。一旦插入，它们就成为微生物附着的滋生地，不仅来自新的表面区域和缝隙，而且还来自与共生状态不同的材料物理化学相互作用。与未接受正畸治疗的人相比，接受正畸治疗的人口腔微生物群的活性存在质和量的差异，这是由于整个治疗期间龈上和龈下微生物菌斑的保留增加所致。这些变化是主要不良影响的根源，例如牙龈炎、白斑病变 (WSL) 和更严重的龋齿病变。值得注意的是，正畸干预前几周的口腔微生物群概况可能是预测和识别健康人群中牙周健康和龋齿风险较高风险个体的一个有价值的指标。抗菌涂层已用于阻止微生物粘附在生物材料上；然而，它们会破坏宿主微生物群，并且一些细菌菌株已经产生了耐药性。可以减少抗菌负荷、防止微生物粘附到正畸矫治器上的智能生物材料已显示出有希望的结果，但其复杂性使许多解决方案无法进入临床。 3D打印技术为复杂的化学合成提供了统一进行的机会，降低了智能生物材料的生产成本，有望在不久的将来进入临床。本综述的目的是强调口腔微生物群在正畸治疗过程中的重要性，并利用创新技术在外科手术过程中更好地维持其健康平衡。