Non-Cochrane · mixed · PM42751289
Anaerobic stress index to predict microbial ecological shifts in clear aligners.
Demirci Mehmet, Unlu Ozge, Kantarci Alpdogan · Journal of oral microbiology · 2026 · PubMed · doi:10.1080/20002297.2026.2701561
Findings
8 findings
| Population | ||||
|---|---|---|---|---|
| Human participants in longitudinal orthodontic microbiome datasets | GCF | Other sampling sites | Shannon alpha diversity GCF | MEAN 2.94 GRADE not reported Studies not reported |
| Clear aligners cohort | Composite anaerobic stress index | Baseline versus treatment timepoint classification | Composite anaerobic stress index discrimination T0 vs T3 · Saliva | AUC 0.90 GRADE not reported Studies not reported |
| Clear aligners cohort | Fusobacterium/Streptococcus ratio | Baseline versus treatment timepoint classification | Fusobacterium/Streptococcus ratio discrimination T0 vs T3 · Plaque | AUC 0.82 GRADE not reported Studies not reported |
| Clear aligners cohort | Composite anaerobic stress index | Baseline versus treatment timepoint classification | Composite anaerobic stress index discrimination T0 vs T3 · Plaque | AUC 0.76 GRADE not reported Studies not reported |
| Fixed appliances cohort | Composite anaerobic stress index | Baseline versus treatment timepoint classification | Composite anaerobic stress index discrimination T0 vs T1/T3 · Saliva | AUC 0.51 GRADE not reported Studies not reported |
| Fixed appliances cohort | Fusobacterium/Streptococcus ratio | Baseline versus treatment timepoint classification | Fusobacterium/Streptococcus ratio discrimination T0 vs T1/T3 · Saliva | AUC 0.40 GRADE not reported Studies not reported |
| Fixed appliances cohort | Fusobacterium/Streptococcus ratio | Baseline versus treatment timepoint classification | Fusobacterium/Streptococcus ratio discrimination T0 vs T1/T3 · Plaque | AUC 0.87 GRADE not reported Studies not reported |
| Fixed appliances cohort | Composite anaerobic stress index | Baseline versus treatment timepoint classification | Composite anaerobic stress index discrimination T0 vs T1/T3 · Plaque | AUC 0.78 GRADE not reported Studies not reported |
Included primary studies 9
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| PRJNA552608 Script theory: differential magnification of affects. PMID:552608 | 1978 | this review only | not stated | not extracted yet |
| PRJNA648248 The central (spinal) canal in congenital murine hydrocephalus: morphological and physiological aspects. PMID:648248 | 1978 | this review only | not stated | not extracted yet |
| PRJNA895208 Age related alterations in purified fructose-1,6-diphosphate aldolase from the nematode Turbatrix aceti. PMID:895208 | 1977 | this review only | not stated | not extracted yet |
| PRJNA905724 [Visually evoked potentials in full-term and premature newborn infants in the 1st days of life]. PMID:905724 | 1977 | this review only | not stated | not extracted yet |
| PRJNA1064555 Plasmids: introductory remarks. PMID:1064555 | 1976 | this review only | not stated | not extracted yet |
| PRJNA1064902 Absorption from different types of iron tablets - correlation between serum iron increase in total absorption of iron. PMID:1064902 | 1976 | this review only | not stated | not extracted yet |
| PRJNA1129082 [Letter: platelet aggregation and assay of Willebrand factor during diabetes mellitus]. PMID:1129082 | 1975 | this review only | not stated | not extracted yet |
| PRJNA1225015 Control of diabetes insipidus by continuous monitoring of the electrical conductivity of the urine with a simple device. PMID:1225015 | 1975 | this review only | not stated | not extracted yet |
| PRJNA1355306 Identification of genetic susceptibility loci for insulin-dependent diabetes in Sudan. PMID:1355306 | 1992 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Human subjects in longitudinal orthodontic microbiome studies; controls systemically and periodontally healthy with no orthodontic therapy | 976 samples (plaque 652, saliva 257, GCF 67) from datasets in China, Japan, USA and Australia (n=10) |
| Intervention | Fixed orthodontic appliances; clear aligners | Fixed appliances (n=10); clear aligners (n=4) |
| Comparison | Matched control group; baseline before appliance bonding or insertion (T0) | Baseline (T0) samples; untreated controls (n=1) |
| Outcomes | Genus-level relative abundance; Shannon alpha diversity; Bray-Curtis beta diversity; Anaerobic Stress Index (ASI); ROC AUC of ASI vs Fusobacterium/Streptococcus ratio | Shannon diversity and PCoA by site; genus relative abundance by site; Actinomyces change in FA plaque; ASI change in CA plaque; ROC AUC of ASI and Fusobacterium/Streptococcus ratio |
| Study designs | Longitudinal human 16S rRNA sequencing datasets with raw FASTQ and complete metadata (NCBI BioProject/SRA) | Longitudinal 16S rRNA sequencing datasets (n=10) |
| Timing | Baseline (T0), 1 month (T1), 3 months (T2), 6 months (T3) | T0 vs T1 (fixed appliances); T0 vs T3 (clear aligners); T0 vs T1/T3 (fixed appliances, ROC) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | NR | Yes | no |
| 2Protocol established before the reviewcritical | NR | No | no |
| 3Choice of study designs explained | NR | No | no |
| 4Comprehensive literature searchcritical | NR | No | no |
| 5Study selection in duplicate | NR | No | no |
| 6Data extraction in duplicate | NR | No | no |
| 7List of excluded studies with reasonscritical | NR | No | no |
| 8Included studies described in detail | NR | Partial Yes | no |
| 9Risk of bias assessed satisfactorilycritical | NR | NRSI: No · RCT: No | no |
| 10Funding of included studies reported | NR | No | no |
| 11Appropriate meta-analysis methodscritical | NR | RCT: No · NRSI: No | no |
| 12Impact of risk of bias on the pooled results | NR | No | no |
| 13Risk of bias accounted for in interpretationcritical | NR | No | no |
| 14Heterogeneity explained | NR | Yes | no |
| 15Publication bias investigatedcritical | NR | No | no |
| 16Conflicts of interest reported | NR | Yes | no |
| Overall | NR | Critically Low | no |