4. Discussion
cleft lip, MPS, orthodontic, palate
ADHESION
This randomized clinical trial was designed to compare the effects of mechanical and chemical cleansing methods on bacterial biofilm attached to acrylic-based removable orthodontic appliances. It was reported that the prevalence of opportunistic pathogens was higher in PMMA-based intraoral devices such as feeding appliances in cleft lip and palate patients, orthodontic retainers, and prosthodontic prostheses [The sample size was estimated based on a pilot study of 8 participants' appliances for cultivated staphylococci counts, with a mean of 1200 CFU for the Lacalut cleaning tablet and 800 CFU for the brushing group. A total of 12 patients were needed per group to yield an alpha value of 0.05 with a study power of 80%. A 10% dropout was estimated, which renders the total sample of 39 patients. The sample size was comparable to many previously published randomized clinical trials conducted on biofilm formation on dentures and disinfection methods.This study showed no significant difference among the cleaning methods on bacterial biofilm in unpolished groups. A similar result was found in the polished groups. It was found that the acrylic resin, i.e., the autopolymerized acrylic resin in this study, was apron to bacterial adhesion due to several surface properties, including surface hydrophobicity, surface free energy, and surface roughness [However, previous clinical trials suggested that brushing reduced denture biofilm formation compared with immersion in a peroxide solution [Regarding the comparison of the polished and unpolished tiles, the data showed that the polished surface significantly facilitated Furthermore, the Lacalut cleaning tablet contains potassium monopersulphate (MPS), a broad-spectrum disinfectant that oxidizes the bacterial protein capsids and evacuates cell content; its action depends on the contact time and concentration [The SEM micrographs showed the superior cleaning results of the combination method, followed by the brushing and the cleaning tablet methods; this was true for the polished and unpolished surfaces; however, there was a dispersed distribution of the bacterial aggregates in the polished samples, which showed a relatively cleaner surface. This agreed with the finding reported by Al Groosh et al. [