Objective: This integrative review aimed to identify studies comparing the periodontal health in patients wearing multibracket orthodontic appliances and clear aligners. Materials and methods: An integrative literature search was performed through different databases, PubMed/Medline, PMC, and the Cochrane Library. This work was submitted to a search strategy following the PICO method and included the focus question: “Could the chosen orthodontic appliance change significantly the oral hygiene of the patient, impairing the periodontal health?” This work included analytical and controlled studies on humans published between 2005 and 2020, in the English language, establishing a comparison of the periodontal status in patients undergoing orthodontic multibracket and clear aligners therapies. The main periodontal indexes assessed were plaque index (PI), pocket depth (PD), gingival index (GI), and bleeding on probing (BoP). Results: The electronic research displayed 386 articles on PMC, 106 on PubMed, and 40 on the Cochrane Library. After removal, just 25 articles were selected for full-text screening, but just eight studies were eligible for this integrative review. It was enumerated that 204 patients were treated with aligners and 294 with multibracket orthodontic appliances, mainly elastomeric ligated brackets. Only the plaque index displayed a significant difference between the two groups and general data obtained showed a better control for periodontal health in the clear aligners. Limitations such as age, malocclusion severity, therapeutic choice, and different time measure was observed. In addition, the oral hygiene instruction and follow-up by a professional were different, and the role of malocclusion was not present in the studies. Conclusions: Within the limitations of this study, better results for periodontal health were found in the clear aligners. Therefore, more studies are necessary to affirm that aligners are synonymous with better gingival conditions in comparison with multibracket appliances. Other variables such as oral hygiene instructions, motivation, and supportive treatment tend to be more prevalent than the type of appliance itself in the periodontal evaluation.

The aim of this systematic review was to evaluate the actual efficacy of Lactobacillus reuteri (L. reuteri) on the periodontal clinical parameters when used concomitantly to the nonsurgical periodontal treatment. Searches were conducted through PubMed Central, Online Knowledge Library, Science Direct, Scielo, and Cochrane databases from 2012 to 2022. The focused question was “In patients with periodontitis, will the probiotic L. reuteri, when administrated as an adjunct to nonsurgical periodontal treatment, compared to the nonsurgical periodontal treatment alone, result in better clinical outcomes?” The following information was extracted from the articles: author and year of publication, type of study, follow-up, sample size and number of defects, and clinical characteristics and details. All included studies were qualitatively assessed using the Critical Appraisal tools according to the Joanna Briggs Institute. Twenty-four articles were full-text reading, but only 9 articles were included. The number of patients enrolled was 287, aged between 18 and 56 years. All periodontal parameters were evaluated. The “follow-up” varied (14, 40, 84, 90, 180, and 360 days). Most articles supported the clinical benefits of L. reuteri as an adjunct to SRP compared to SRP alone. A common finding at the beginning period was thatno statistically different results were observed between the test and control groups; otherwise, at the last period, a significant improvement was found in favor of the probiotic use (p = 0.001) for all the clinical parameters. The use of L. reuteri as an adjunct to nonsurgical periodontal treatment may result in significantly better clinical outcomes than nonsurgical periodontal treatment alone; but the conclusion must be carefully interpreted because of the heterogeneity found among the studies.