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Fixed orthodontic appliances (FOA) temporarily interfere with periodontal health of patients, as the appliance complicates oral hygiene. The use of aligners in orthodontic therapy increased strongly during the last decade. In the literature, the reports about effects of aligner treatment on oral hygiene and gingival conditions are scarce. This cros...
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This investigation evaluated clinical parameters and the levels of polymorphonuclear leukocytes [PMN] collected in an oral rinse amongst subjects who refrained from dental hygiene for a period of 12 days.
Methods
Study enrolled consenting adults and assigned to a non-prophy group [n = 16] and a separate prophy group [n = 27]. Both groups underwent...
Citations
... Different studies showed that clear aligner therapy improves patients' periodontal health more than fixed appliances [41]. There were no statistically significant changes in probing depth and bleeding on probing in patients using clear aligners in both the long and short term [42]. The accumulation of plaque is the primary cause of gingivitis. ...
The demand for dental treatment with multiple orthodontic appliances has recently increased for aesthetic purposes. Still, these appliances are not free from some negative influences that may affect the teeth and gingiva, especially periodontium, due to plaque accumulation during treatment. Therefore, special recommendations must be given to orthodontic patients, and they must be encouraged to take care of oral and dental hygiene during the orthodontic treatment period. Thus, this review aimed to identify and summarize the different effects of the various orthodontic appliances on the periodontium and the composition of the microbial community.
... An obvious advantage of using aligners compared with fixed braces is the ease of dental hygiene during treatment, which can range from several months to years. This makes it easier to avoid certain complications such as dental caries, inflammatory periodontal diseases, and tooth decalcification [25,26]. However, treating IC with aligners can be challenging, especially without additional support like mini-implants [20]. ...
Canines have a fundamental role in the dental arch, both aesthetically and functionally. Apart from the third molars, maxillary canines are the most frequently impacted teeth. Orthodontic traction of an impacted canine is one of the most appropriate approaches when there is a good prognosis, in growing patients and without a serious lack of space in the arch. This systematic review aims to describe the different approaches used in orthodontic traction of impacted canines and evaluate their effectiveness. PRISMA guidelines were used to perform a bibliographic search on the referenced platform PubMed. Articles published between 2014 and May 2024 were selected. Nine articles were included, and another five were added by manual search. The most studied methods were the transpalatal arch, the mini-implant, and the cantilever spring, which prove to be quite effective. Aligners, when combined with auxiliary methods, have been demonstrated to be a viable and effective alternative to conventional techniques. However, further research is required. Despite there being no consensus among authors as to which is the most effective method, choosing the correct traction approach through an accurate diagnosis and treatment planning is crucial for the successful orthodontic treatment of impacted canines.
... Şeffaf plak hastalarının sabit aparey hastalarına kıyasla daha iyi periodontal sağlığa sahip olduğu gösterilmiştir. 20 Özele, periodontal hastalık kontrol altına alınmadan, inflamasyon azaltılmadan ve hasta özenle ağız hijyeni önlemlerine uyduğunu göstermeden ortodontik tedaviye başlanmamalıdır. Tedavi süreci boyunca periodontal durum yakından izlenmelidir. ...
Orthodontic tooth movement generates biomechanical forces that can cause changes in the surrounding periodontal tissues, which can affect the stability and health of the supporting tissues. Conversely, the presence of periodontal disease, characterized by gingivitis, bone loss and loss of attachments, can complicate orthodontic treatment by compromising the periodontal support necessary for safe and effective tooth movement. Therefore, a comprehensive, multidisciplinary approach that includes both orthodontic and periodontal management is essential to achieve optimal treatment outcomes while maintaining the long-term health of periodontal tissues. This review examines the bidirectional relationship between orthodontics and periodontics, emphasizing the importance of collaborative care to reduce risks, improve treatment outcomes and promote sustainable oral health.
... Initially, clear aligner therapy with Invisalign® (Align Technology, San Jose, CA, USA) was limited to adult patients in the permanent dentition [1]. However, in 2008, the introduction of Invisalign® Teen (Align Technology, San Jose, CA, USA) has extended this spectrum to adolescents, increasing the group of patients who can be treated with clear aligners considerably [2][3][4][5][6]. Furthermore, it is now possible to treat more and more complex cases with clear aligners, though closing extraction spaces remains one of the most challenging tasks. ...
... The recommended wear time for clear aligners is 22 h daily, covering both teeth and the gingival margin. This is raising concerns about periodontal inflammation [2][3][4][5][6]. Compared to fixed appliances, clear aligner therapy offers the notable advantage of simplifying daily oral hygiene through its removable design, while maintaining precise three-dimensional control of tooth movements (Fig. 1a) [7][8][9]. ...
Objectives
This prospective study aimed to evaluate periodontal inflammation in adolescents undergoing orthodontic treatment with clear aligners (Invisalign® Teen, Align Technology, San Jose, CA, USA). Key objectives included assessing the presence of 11 periodontitis-associated marker bacteria, active matrix metalloproteinase-8 concentrations in sulcular fluid, and the influence of IL-1 polymorphism genotypes on periodontal health.
Materials and methods
Fifty adolescent patients (13.3 ± 1.8 years) with mixed and permanent dentition participated. Gingival crevicular fluid samples were analyzed at multiple time points: before, during, and one year after aligner treatment. Periodontal health was assessed using the Gingivitis Index and the Modified Quigley-Hein Index. Genotypic analysis of IL-1 polymorphism was also performed. Statistical analyses included mixed linear models and generalized linear models to explore correlations.
Results
All combinations of IL-1 polymorphism genotypes were found in the sample. No significant increase in periodontal inflammation or aMMP-8 concentrations was observed over the treatment period. Marker bacteria from the red and orange-associated complexes remained at low levels, while significant changes occurred in the orange and green complexes, particularly Capnocytophaga spp. (p = 0.0042) and Fusobacterium spp. (p = 0.0365). GI correlated significantly with aMMP-8 levels (p = 0.0017), but no genotype effect on GI was observed. MQH showed associations with pathogens from the orange and green complexes, including Capnocytophaga spp. and Fusobacterium spp.
Conclusions
Clear aligner treatment in adolescents, including those with an unfavorable genotype, does not increase periodontal inflammation when accompanied by good oral hygiene.
Clinical relevance
Regular periodontal monitoring and hygiene reinforcement is important during orthodontic treatment, especially in adolescent patients.
... 3 However, wearing fixed appliances can increase the risk of tooth surface decalcification and periodontal problems. [4][5][6][7] Moreover, patients may experience discomfort during eating and daily activities. 8,9 Clear aligners offer distinct advantages over fixed appliances, including superior aesthetics, enhanced comfort, and improved oral hygiene. ...
Root movements and the rotation of a round-shaped tooth are known to be particularly challenging using clear aligners. This case report describes effective and efficient hybrid mechanics, combining aligners and a micro-implant uprighting cantilever, to correct a rotated and angulated mandibular canine. A 28-year-old male patient sought treatment for moderate crowding and presented with a severely rotated and angulated right mandibular canine, which required significant root movement to correct. Despite 12.5 months of treatment using a bracketless wire in resin slots plus clear aligners, the canine rotation and angulation remained uncorrected. Consequently, a nickel–titanium cantilever supported by a micro-implant was added to the aligner treatment. The desired mesial-out crown rotation and distal root movement of the canine occurred in 5.5 months. Adding an auxiliary cantilever when treating severely rotated and angulated teeth in clear aligner treatment is worthy of consideration.
... 3 However, wearing fixed appliances can increase the risk of tooth surface decalcification and periodontal problems. [4][5][6][7] Moreover, patients may experience discomfort during eating and daily activities. 8,9 Clear aligners offer distinct advantages over fixed appliances, including superior aesthetics, enhanced comfort, and improved oral hygiene. ...
Root movements and the rotation of a round-shaped tooth are known to be particularly challenging using clear aligners. This case report describes effective and efficient hybrid mechanics, combining aligners and a micro-implant uprighting cantilever, to correct a rotated and angulated mandibular canine. A 28-year-old male patient sought treatment for moderate crowding and presented with a severely rotated and angulated right mandibular canine, which required significant root movement to correct. Despite 12.5 months of treatment using a bracketless wire in resin slots plus clear aligners, the canine rotation and angulation remained uncorrected. Consequently, a nickel-titanium cantilever supported by a micro-implant was added to the aligner treatment. The desired mesial-out crown rotation and distal root movement of the canine occurred in 5.5 months. Adding an auxiliary cantilever when treating severely rotated and angulated teeth in clear aligner treatment is worthy of consideration.
... Although numerous studies and literature reviews [8,9,[17][18][19] have researched the oral health conditions of patients treated with aligner therapy, highlighting better periodontal and cariologic conditions compared to those treated with fixed therapy, only a few studies have evaluated the microbiological aspect of this kind of therapy and no literature review is present. Since the analysis of microbiota is fundamental to achieving a real understanding of clinical oral health conditions, the purpose of the present study is to conduct a systematic review of the articles published in the last 10 years in order to address the following questions: ...
Aim
The oral microbiome plays a fundamental role in maintaining homeostasis of the oral cavity. In the last decade there has been an increasing use of clear aligners, which guarantee aesthetics and comfort for the patient. The aim of this work is to conduct a systematic review regarding the alterations in bacterial flora and oral health with aligner and fixed orthodontic therapy.
Design
A systematic review was conducted following the PRISMA Statement. Using the search strategy “(clear aligners OR Invisalign) AND (fixed therapy OR fixed orthodont * therapy) NOT (thermoplastic retainers) AND (oral microbiome OR oral microbiota * OR oral microbiology * OR oral health)”, in the main scientific databases. Two scales were applied to assess the quality of scientific evidence: ROBINS-I and RoB 2.
Results
A total of 484 articles emerged of which 9 met our inclusion/exclusion criteria. Afterwards the application of the rating scales, 1 article was found to be at low risk of bias, 6 at moderate and 2 at serious risk of bias.
Conclusion
Both therapies cause an alteration of the oral microbiome, but the changes induced by the aligners seem to be compatible with a better oral health compared to fixed appliances.
... In fact, miethke (28) 2005 had significantly lower plaque rates with aligners and almost identical periodontal status. However, Azaripou (29) showed significantly better gingival with aligners, better periodontal health and less plaque with aligners, but not significantly. Poor hygiene and poor control during orthodontic treatment can lead to tooth loss (Q25), which is of great concern to patients both at the beginning and after six months. ...
Background
Despite the technological advances made in dentistry, anxiety and fear of pain due to dental treatment are still common. Most patients in a dental clinic suffer some symptoms of anxiety, which can appear at different times. The objective is to know the degree of anxiety and the factors associated with this anxiety during orthodontic treatment.
Material and Methods
180 adult patients who started orthodontic treatment were selected and a questionnaire was administered at the beginning and after six months of treatment. The SDAI anxiety scale was used to determine the degree of anxiety and its own questionnaire to determine its relationship with the different factors of orthodontic treatment.
Results
When performing descriptive and inferential statistics, it is obtained that 72% of patients at the beginning of orthodontic treatment present a certain degree of anxiety. Through individual logistic regression using anxiety as a response and each of the demographic variables at six months as predictors, it is obtained that gender(OR=3.15) and occupation(OR=3.11) are the two significant predictors (P<0, 05). Using Fisher’s exact test of independence, the additional questions are related to the demographic variables and anxiety, obtaining a value of P<0.05 in 27(of 114) non-independent relationships between the additional questions and the demographic/anxiety variables.
Conclusions
38%of patients who begin orthodontic treatment have high anxiety, but after 6 months this anxiety drops to 22%. Women and patients with active work are the most likely to present more anxiety at 6 months. The biggest concerns at the beginning of treatment are: Changes in appearance(Q15),Eating(Q18),Appliance loss(Q19),Hygiene(Q24),Tooth loss(Q25),Extend treatment(Q26),Expectations(Q27) and Retention(Q28).Of these eight, only three continue to worry patients after six months: appliances loss(Q19),Hygiene(Q24) and Tooth Loss(Q25).At the beginning of treatment there are two questions that do not worry: Enter alone(Q10) and take medications(Q21).Four more are added after six months: Embarrassment(Q16),Getting used to it(Q17),Periodic visits(Q22) and Emergencies(Q23).
Key words:SDAI scale, Dental anxiety, Adults, Orthodontic treatment.
... In recent years, the demand for orthodontic treatments with aesthetic appliances has increased exponentially, leading to the widespread adoption of clear aligner therapy (CAT). Clear aligners also offer several advantages over traditional fixed orthodontic appliances, including enhanced comfort, reduced frequency of emergencies, improved oral hygiene, and minimized soft tissue irritation [1][2][3][4][5][6]. ...
Objectives: This study aimed to evaluate the effectiveness of a novel hybrid aligner system, Geniova Technologies™ (GT), for arch expansion and to compare the predictability of its virtual setup with a conventional clear aligner system (CA) after the first treatment phase. Materials and Methods: Forty (mean age: 31.3 years for GT, 38.4 years for CA) adult patients with maxillary dentoalveolar compression and anterior crowding >3 mm were enrolled and assigned to GT and CA groups. Transverse changes for canines and premolars were measured at the cusp and cervical levels. Results: No significant baseline differences in transverse dimensions were found between groups. Treatment duration (4.25 months for GT vs. 9.75 months for CA) and the number of aligners (4.25 in GT vs. 28.25 in CA) significantly differed (p < 0.001). At the cusp level, mean transverse expansions for the maxillary first premolars were 2.78 mm (GT) and 2.44 mm (CA). However, effectiveness comparisons revealed no significant differences in expansion outcomes, with both groups showing similar accuracy. Conclusions: The GT group achieved comparable dentoalveolar expansion of canines and premolars in significantly less time and with fewer aligners than the CA group. The predictability of virtual setup measurements was similar for both systems, confirming their comparable performance in achieving planned expansion.
... Orthodontic treatment using aligners allows for easier oral hygiene, consequently promoting good periodontal health in patients, as evidenced by the reduction in plaque levels, gingival inflammation, and bleeding on probing 12,14,[19][20][21][22] . Several factors may be related to improved dental hygiene in patients using aligners, such as the older age of patients (usually adults), higher patient motivation, a significant increase in brushing frequency, and the removable nature of the appliance 19,23 . ...
Introduction The impact of aligners in the periodontal conditions and protocols for hygiene were investigated. Objective This study assessed the periodontal condition of patients undergoing orthodontic treatment with ClearCorrect aligners and compare periodontal health conditions after the use of BlueM mouthwash and foam as clinical protocols for oral and aligner hygiene. Material and method In 16 patients’ treatment was performed using aligners, and a periodontal follow-up was conducted. The sample was divided into 3 randomized groups: Control, Mouthwash, and Foam, with each patient passing through all groups. The use of a standardized toothpaste was indicated. A periodontal examination was performed on baseline and every 2 months using gingival sulcus probing, insertion level, recession, bleeding on probe index, and biofilm presence. Result Significant differences were observed in distal probing of the teeth when comparing baseline and the mouthwash group in the intergroup analysis, irrespective of the side of the mouth and the tooth evaluated. When assessing bleeding on probe, baseline showed 1.8 times more risk of bleeding on probe than foam, 1.9 times more risk than the control, and 2.4 times more than mouthwash group. Regarding biofilm presence, baseline data showed 1.4 times more risk of having biofilm than foam, and 1.9 times more risk than mouthwash groups. In relation to the control, there was no statistically significant difference. Conclusion Patients when using BlueM mouthwash had a lower chance of bleeding on probe and presence of biofilm, as well as an improvement in distal periodontal probing depth when compared to baseline situation.
