Teenagers treated with removable appliances display better compliance with oral hygiene, less plaque, and fewer gingival inflammatory reactions than their peers with fixed appliances.

Objective:The aim of this prospective study was to compare the periodontal health and the microbiological changes via real-time polymerase chain reaction (PCR) in patients treated with fixed orthodontic appliances and Invisalign® system (Align Technology, Santa Clara, California).Materials and Methods:Seventy-seven patients were enrolled in this study and divided into three groups (Invisalign® group, fixed orthodontic appliances group and control group). Plaque index, probing depth, bleeding on probing were assessed. Total biofilm mass and periodontal pathogens were analyzed and detected via real-time PCR. All these data were analyzed at the T0 (beginning of the treatment) T1 (1-month) and T2 (3 months); and statistically compared using the Mann–Whitney test for independent groups.Results:After 1-month and after 3 months of treatment there was only one sample with periodontopathic anaerobes found in patient treated using fixed orthodontic appliances. The Invisalign® group showed better results in terms of periodontal health and total biofilm mass compared to the fixed orthodontic appliance group. A statistical significant difference (P < 0.05) at the T2 in the total biofilm mass was found between the two groups.Conclusion:Patients undergoing orthodontic treatment with the Invisalign® System show a superior periodontal health in the short-term when compared to patients in treatment with fixed orthodontic appliances. Invisalign® should be considered as a first treatment option in patients with risk of developing periodontal disease.

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Objectives: The use of removable orthodontic appliances minimizes the negative effects on periodontal health allowing patients to carry out oral hygiene without obstacles. The aim of this preliminary study was to evaluate microbiological and clinical changes presented during the first three months of orthodontic therapy in adults with fixed appliances and Invisalign® System (Align Technology, Santa Clara, California). Materials and Methods: Plaque Index (PI), Probing Depth (PD), Bleeding on probing (BOP), Compliance to oral hygiene and subgingival microbial samples were assessed in 30 patients. Samples were analyzed by real time PCR to detect periodontal pathogens and microbial biofilm mass. A statistical comparison was made over time and amongst the three groups, using Chi-square X2, Odds Ratios (OR), Regression analysis (DOE) and ANOVA. Results: After 30 and 90 days of treatment there was only one sample with periodontopathic anaerobes found in a patient treated using fixed orthodontic appliances. Direct influence of orthodontic treatment on compliance and less subgingival biofilm mass were found with Invisalign® patients who increased the time dedicated to oral hygiene. A decrease on PD (p=0,002) and BOP (p<0,001) was detected in the Invisalign® group after 90 days of treatment. Conclusions: In this preliminary study, fixed and removable appliances did not increase the risk for periodontal disease in patients undergoing orthodontic therapy. However, the removable Invisalign® appliances may facilitate oral hygiene procedures, maintaining a lower level of microbial biofilm mass, even with poor oral hygiene compliance, minimizing the negative effects on gingival inflammation

Objectives. To evaluate substance P (SP) and the effect of ketoprofen administration, a nonsteroidal anti-inflammatory drug (NSAID), on SP in the pulp of upper third molars with experimentally induced pulpal lesion. Materials and Methods. A sample of 20 young systemically healthy adults of both sexes, nonsmokers, with a healthy upper third molar to extract for orthodontic purposes, was selected. Prior to the procedure, an inflammatory process was generated by mechanical exposure of the pulp. After 15 minutes, the pulp was collected using a sterile barbed broach. SP levels were determined by using a commercially available enzyme immunoassay (ELISA) kit. The subjects were randomly divided into two groups: group 1 received a dose of ketoprofen 30 minutes prior to the experimental procedure. The subjects of group 2 did not receive any kind of drug administration. The patients were asked to complete a diary on the postoperative pain. Results. No statistically significant difference could be detected in SP expression between the two groups. In group 1, pain manifestation was significantly delayed in comparison with group 2. Conclusions. Preventive administration of ketoprofen did not significantly affect the pulpal levels of SP but resulted in a significantly postponed manifestation of pain after extraction.