Periodontal health status in patients treated with the Invisalign® system and fixed orthodontic appliances: A 3 months clinical and microbiological evaluation

Levrini, Luca; Mangano, Alessandro; Montanari, Paola; Margherini, Silvia; Caprioglio, Alberto; Abbate, Gian Marco

doi:10.4103/1305-7456.163218

Cited by 107 publications

(115 citation statements)

References 35 publications

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“…Nevertheless, the oral hygiene improved in both groups during the entire course of the study [26]. A study by Levrini and co-workers pointed out that patients undergoing orthodontic treatment with clear aligners prompted a lower total biofilm mass accumulation in the short term when compared with patients in treatment with fixed orthodontic appliances, suggesting the use of clear aligners as a first treatment option in patients who are at risk of developing periodontal diseases [27]. Two recent meta-analyses underlined that clear aligners should be used in patients with high risk of gingival inflammation, but the level of evidence was very low and more high-quality studies are required to corroborate these results [28,29].…”

Section: Discussionmentioning

confidence: 93%

Impact of Fixed Orthodontic Appliance and Clear Aligners on the Periodontal Health: A Prospective Clinical Study

et al. 2020

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This study aimed to evaluate the periodontal health of orthodontic patients with supportive periodontal therapy in a 3 month follow-up. The sample comprised 20 patients (mean age 20.6 ± 8.1 years) in treatment with multibracket fixed appliances (fixed group—FG) and 20 patients (mean age 34.7 ± 12.5 years) in treatment with clear aligners (clear aligners group—CAG). At baseline (T0) and after 3 months (T1), probing depth (PD), plaque index (PI), bleeding on probing (BOP), and gingival recession (REC) were measured. Patients were trained to perform an individualized tooth brushing technique, and every 2 weeks they were re-called to reinforce the oral hygiene instructions. The intra-group comparisons (T1 vs. T0) were calculated with the Wilcoxon signed-rank test, while a linear regression model was used for the inter-group comparisons (FG vs. CAG). The significance level was set at p < 0.05. Statistically significant decrease in both groups was found for PD (FG: Δ, −9.2 inter-quartile range (IQR), −22.5, −5.5; CAG: Δ, −12.6 IQR, −25.4, −4.8), BOP (FG: Δ, −53.5 IQR, −70.5, −37; CAG: Δ, −37.5 IQR, −54.5, −23), and PI (FG: Δ, −17.5 IQR, −62.5, 14.5; CAG: Δ, −24 IQR, −49.5, −5). The result of the linear regression models suggested that the type of appliance did not have any effects on the improvement of periodontal variables. Therefore, patients undergoing orthodontic treatment with fixed appliances and clear aligners did not show differences in gingival health when followed by a dental hygienist.

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Section: Discussionmentioning

confidence: 93%

Impact of Fixed Orthodontic Appliance and Clear Aligners on the Periodontal Health: A Prospective Clinical Study

et al. 2020

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“…In 37 of the 52 articles presented with moderate methodological quality [9–21,24–26,28,29,31–33,35–39,41–46,51–53,56,57], the major concern was the absence of repeatability tests. One article had a high quality [40] and the remaining 13 papers were classified as having a low quality [3,4,22,23,27,30,34,47–50,54,55].…”

Section: Resultsmentioning

confidence: 99%

“…Six studies analyzed removable devices [11,17,18,31,49,52]. One study analyzed different interceptive removable appliances [49], demonstrating an increase in both S. mutans and Lactobacillus spp.…”

Section: Resultsmentioning

confidence: 99%

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Changes in oral microbiota due to orthodontic appliances: a systematic review

Lucchese

Bondemark

Marcolina

et al. 2018

Journal of Oral Microbiology

141

115

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Background: Oral microbiota has been at the center of cultural attention in recent years. In daily clinical practice, orthodontic appliances may be associated with an increased cariogenic risk and a worsening of preexisting periodontal diseases.Objective: The purpose of this review is to investigate the available evidence regarding the association between orthodontic appliances and changes in the quality and quantity of the oral microbiota.Design: The research included every article published up to October 2017 featuring the keywords ‘Orthodontic appliance* AND (microbiological colonization OR periodontal pathogen* OR Streptococcus mutans OR Lactobacillus spp. OR Candida OR Tannerella forsythia OR Treponema denticola OR Fusobacterium nucleatum OR Aggregatibacter actinomycetemcomitans OR Prevotella intermedia OR Prevotella nigrescens OR Porphyromonas gingivalis)’ and was conducted in the major medical databases. The methodological quality of selected papers was scored using the ‘Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies’ (SBU) method.Results: Orthodontic appliances influence the oral microbiota with an increase in the counts of S. mutans and Lactobacillus spp. and in the percentage of potentially pathogenic gram-negative bacteria.Conclusions: There is moderate/high evidence regarding the association between orthodontic appliances and changes in the oral microbiota.PROSPERO registration number CRD42018091589.

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“…Furthermore, orthodontic treatment with clear aligners guarantees better periodontal health compared to fixed orthodontic appliances [30][31][32][33][34]. Despite this, oral hygiene and periodontal status should be regularly checked after surgery and throughout the period of orthodontic movements [1,27], particularly in patients that smoke [35].…”

Section: Discussionmentioning

confidence: 99%

Management of a Facilitated Aesthetic Orthodontic Treatment with Clear Aligners and Minimally Invasive Corticotomy

et al. 2020

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Accelerating orthodontic tooth movement has become a topical issue and the corticotomy seems to be the only effective and safe technique reported in the literature. Simultaneously, aesthetic orthodontic treatment with removable clear aligners has become commonly requested. The aim of this paper is to illustrate the management of facilitated aesthetic orthodontic treatment, a combined approach including piezocision corticotomy and clear aligners for orthodontic treatment. Orthodontic planning for traditional clear aligners should be modified to take advantage of the corticotomy technique in order to facilitate the most difficult orthodontic movements needed to achieve treatment completion, where each aligner will be used for four days rather than 15 days for a total time of four months. A corticotomy with a modified minimally invasive flapless piezocision technique should be performed in both jaws at the same time, before the time window of the orthodontic treatment, where the most difficult orthodontic movements are planned. Treatment planning where difficult orthodontic movements, such as anterior open-bite closure and extraction space closure, are easily managed with clear aligners and are presented as examples of facilitated aesthetic orthodontic treatment application. The combination between aesthetic treatment with clear aligners and modified piezocision corticotomy, if carefully planned, seems to represent a synergy that achieves the current goals of orthodontic treatment. The primary objectives of this combination should be facilitating difficult orthodontic movements and reducing treatment duration.

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Periodontal health status in patients treated with the Invisalign® system and fixed orthodontic appliances: A 3 months clinical and microbiological evaluation

Cited by 107 publications

References 35 publications

Impact of Fixed Orthodontic Appliance and Clear Aligners on the Periodontal Health: A Prospective Clinical Study

Impact of Fixed Orthodontic Appliance and Clear Aligners on the Periodontal Health: A Prospective Clinical Study

Changes in oral microbiota due to orthodontic appliances: a systematic review

Management of a Facilitated Aesthetic Orthodontic Treatment with Clear Aligners and Minimally Invasive Corticotomy

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