Microbial distribution and secretory IgA level among crossbite patients at an early stage of comprehensive orthodontic treatment

Background: Crossbite is any discrepancy in the relationship between the upper and lower teeth. Crossbites have a relationship with oral microorganisms, such as S. mutans and lactobacillus infections. Viral infections can spread to the oral cavity especially its soft tissue especially herpes simplex virus & cytomegalovirus. Secretory immunoglobulin represents a factor for acquired immunity in the oral cavity which is associated with oral infection and variation. Objectives: Isolation of microbes from crossbite patients, identifying by molecular techniques, determining sIgA level, and selecting appropriate antibiotics for the most common microbe. Materials and Methods: A total of 60 (30 samples of saliva and swab before Orthodontic Treatment and 30 samples of saliva after Orthodontic) during the period from October 2021 to April 2022, Sample were taken from patients and microbiological identification by microscopical and biochemical tests. An antibiotic sensitivity test for S. mutans. Genetic identification was detected in the S. mutans samples by using specificity Sm479 primers, and HCMV primers for cytomegalovirus. Secretory IgA was determined by ELISA Kit. Results: A number of gram-positive bacteria were more than gram-negative (51% and 49%) respectively. The S. mutans and Lactobacillus are the most frequent among the other species, followed by Candida, Klebsiella, and S. epidermidis. 53% in male, while 47% in female, and age group (1315) was the most prevalent among samples 53%. Regarding S. mutans, the highest sensitive rate is Erythromycin 81%, followed by Amoxiclav 57%, Vancomycin 52%, and Nalidixic acid 43%. Conclusion: Most infectious cases were in ages (14-15) years. S. mutans is more prevalent among bacterial infections, molecular detection by PCR more specifically for S.mutans and CMV virus, sIgA level non-significant inverse correlations between age and sIgA level before treatment, while significant inverse correlation between age and sIgA level after treatment, and S. mutans, reported the highest sensitive rate is Erythromycin (81%), followed by Amoxiclav, Vancomycin,and Nalidixic acid.