Research Article ATP Bioluminometers Analysis on the Surfaces of Removable Orthodontic Aligners after the Use of Different Cleaning Methods Luca Levrini, 1 Alessandro Mangano, 2 Silvia Margherini, 2 Camilla Tenconi, 2 Davide Vigetti, 3 Raffaele Muollo, 2 and Gian Marco Abbate 2 1 Department of Surgical and Morphological Sciences, Oro Cranio Facial Disease and Medicine Research Center, Dental Hygiene School, University of Insubria, Via Giuseppe Piatti 10, 21100 Varese, Italy 2 Oro Cranio Facial Disease and Medicine Research Center, University of Insubria, 21100 Varese, Italy 3 Department of Surgical and Morphological Sciences, University of Insubria, 21100 Varese, Italy Correspondence should be addressed to Luca Levrini; luca.levrini@uninsubria.it Received 20 February 2016; Accepted 14 April 2016 Academic Editor: Tomas Fortin Copyright © 2016 Luca Levrini et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. Te aim was to quantify the bacteria concentration on the surface of orthodontic clear aligners using three diferent cleaning methods. Furthermore the objective was to validate the efcacy of the bioluminometer in assessing the bacteria concentration. Materials and Methods. Twenty subjects (six males and fourteen females) undergoing orthodontic therapy with clear aligners (Invisalign5 Align Technology, Santa Clara, California) were enrolled in this study. Te observation time was of six weeks. Te patients were instructed to use diferent cleaning methods (water, brushing with toothpaste, and brushing with toothpaste and use of sodium carbonate and sulphate tablet). At the end of each phase a microbiological analysis was performed using the bioluminometer. Results. Te highest bacteria concentration was found on aligners cleaned using only water (583 relative light units); a value of 189 relative light units was found on aligners cleaned with brushing and toothpaste. Te lowest bacteria concentration was recorded on aligners cleaned with brushing and toothpaste and the use of sodium carbonate and sulfate tablet. Conclusions. Te mechanical removal of the bacterial bioflm proved to be efective with brushing and toothpaste. Te best results in terms of bacteria concentration were achieved adding the use of sodium carbonate and sulfate tablet. 1. Introduction Traditional fxed orthodontic appliances lead to a change in the quantity and in the composition of oral microbiota. Fixed orthodontic devices cause plaque accumulation, impede cor- rect professional hygiene procedures, and potentially cause enamel demineralization, tooth decay, and periodontal dis- ease [1–6]. Digital dentistry is a fast moving feld and new technologies give both the clinicians and patients new treat- ment possibilities. In 1999 a new orthodontic appliance based on a polymer composed of a chain of organic units joined with urethane links was introduced (Invisalign, Align Tech- nology, Santa Clara, California) and produced with a CAM (computer aided manufacturing) technology as a removable appliance able to gradually move the teeth according to a computer designed treatment plan. Te introduction of this technology gave the patients the possibility to better control the oral hygiene. In fact, the use of removable orthodontic devices guarantees a normal professional hygiene cleaning, thus reducing the risk of developing plaque related diseases [7–9]. Te use of removable clear aligners showed, also, a better patient compliance in terms of oral hygiene procedures [10]. In the case of removable aligners it is important that before use they are cleaned and without bacteria. A correct hygiene is able to impede the accumulation of bacteria on the surfaces, thus avoiding the potential risk of spreading bacteria on teeth surfaces and periodontium. Terefore, it is important to clean and disinfect the removable aligners, but information given to patients is ofen incomplete and unclear. Tis could be attributable to a lack of evidence in the Hindawi Publishing Corporation International Journal of Dentistry Volume 2016, Article ID 5926941, 6 pages http://dx.doi.org/10.1155/2016/5926941