ABSTRACT
Background:
Orthodontic therapy is often used to cure dental malocclusions; however, since orthodontic equipment is difficult to keep clean, it might have an adverse effect on periodontal health. Clear aligners and fixed braces are two common orthodontic treatments.
Materials and Methods:
In this research, 100 patients receiving orthodontic treatment at a dental clinic ranged in age from 18 to 35. Two sets of patients were created: 50 with transparent aligners and 50 with fixed braces. At baseline, three months, and six months, periodontal health was evaluated using the plaque index (PI), gingival index (GI), and probing depth (PD). Both groups received advice on oral hygiene. SPSS software was used for data analysis, with a significance level of P < 0.05 for statistical analysis.
Results:
PI, GI, and PD did not vary significantly between the two groups at baseline (P > 0.05). PI (2.3 ± 0.4) and GI (1.8 ± 0.3) in the fixed braces group were significantly higher after three months than in the clear aligners group (PI: 1.5 ± 0.3, GI: 1.2 ± 0.2, P < 0.05). At six months, the group using fixed braces had a substantially higher PD (3.5 ± 0.5 mm) than the group wearing transparent aligners (2.8 ± 0.4 mm, P < 0.05). Throughout the course of the trial, the group using transparent aligners had greater periodontal health.
Conclusion:
In comparison with patients wearing fixed braces, individuals using transparent aligners showed improved periodontal health, as seen by decreased levels of plaque buildup, gingival inflammation, and probing depth. For individuals who are worried about their periodontal health while undergoing orthodontic treatment, clear aligners could be a better choice.
KEYWORDS: Clear aligners, fixed braces, gingival index, periodontal health, plaque index, probing depth, orthodontics
INTRODUCTION
Fixed braces, which are made up of brackets and wires, effectively regulate how teeth move. However, because of their intricate design, they may make maintaining oral hygiene more difficult, which can increase plaque buildup and result in periodontal problems.[1,2] Clear aligners, on the other hand, are detachable and provide more access to tooth surfaces, which may lower the risk of periodontal issues.[3,4]
Because maintaining proper dental hygiene may be difficult during orthodontic treatment, periodontal health—a crucial component of overall oral health—may suffer. In orthodontic appliances, plaque buildup and gingival irritation are frequent problems that, if left untreated, may lead to gingivitis and periodontitis.[5] This research has shown differing effects on periodontal health between clear aligners and fixed braces; some findings indicate that aligners may provide better results in terms of periodontal parameters.[6,7]
Even though transparent aligners are becoming more and more popular, further study is needed to compare their effects on periodontal health to those of permanent braces. For a six-month treatment term, this research compares and assesses the periodontal health results of individuals using clear aligners vs fixed braces, with an emphasis on important periodontal indices, such as the plaque index (PI), gingival index (GI), and probing depth (PD). When proposing orthodontic treatment choices to patients who are worried about their periodontal health, professionals will be more equipped to make educated judgments if they are aware of these variations.
MATERIALS AND METHODS
The research included 100 participants seeking orthodontic treatment between the ages of 18 and 35 years. Two sets of patients were randomly assigned: 50 patients got clear aligners and 50 patients received fixed braces. The Institutional Review Board (IRB) authorized the trial, and each participant gave their informed permission.
Criteria for inclusion and exclusion
Patients who met the following requirements were eligible: no prior orthodontic treatment, no history of periodontal disease, and excellent overall health. The use of drugs impacting gingival conditions, smoking, and systemic disorders affecting periodontal health were all considered exclusion criteria.
Treatment for orthodontics
Conventional metal brackets and archwires were provided to patients in the fixed braces group. At the beginning of therapy, instructions on maintaining good oral hygiene were given, including how to use fluoride toothpaste and interdental brushes. The patients in the clear aligners group had aligners treatment, and they were told to wear them for 22 hours a day, taking them out only for dental hygiene and meals.
Plaque index (PI), gingival index (GI), probing depth (PD), and periodontal assessment was done for all.
Analytical statistics
STATA version 23 was used to analyze the data.
RESULTS
The study that included 100 patients were divided into two groups: 50 patients with fixed braces and 50 patients with clear aligners. The demographic characteristics were similar between the two groups, with no significant differences in age, gender distribution, or baseline periodontal indices (P > 0.05).
Periodontal indices
The periodontal health of patients was assessed using the plaque index (PI), gingival index (GI), and probing depth (PD) at baseline, three months, and six months. The results are presented in Tables 1, 2 and 3.
Table 1.
Plaque index (PI) scores
| Time Point | Fixed Braces (Mean±SD) | Clear Aligners (Mean±SD) | P |
|---|---|---|---|
| Baseline | 1.0±0.3 | 1.0±0.3 | 0.895 |
| 3 Months | 2.3±0.4 | 1.5±0.3 | 0.001 |
| 6 Months | 2.6±0.5 | 1.7±0.4 | 0.001 |
Table 2.
Gingival index (GI) scores
| Time Point | Fixed Braces (Mean±SD) | Clear Aligners (Mean±SD) | P |
|---|---|---|---|
| Baseline | 0.9±0.2 | 0.9±0.2 | 0.912 |
| 3 Months | 1.8±0.3 | 1.2±0.2 | 0.001 |
| 6 Months | 2.1±0.4 | 1.3±0.3 | 0.001 |
Table 3.
Probing depth (PD) scores (mm)
| Time Point | Fixed Braces (Mean±SD) | Clear Aligners (Mean±SD) | P |
|---|---|---|---|
| Baseline | 2.5±0.4 | 2.5±0.4 | 0.863 |
| 3 Months | 3.2±0.5 | 2.7±0.4 | 0.002 |
| 6 Months | 3.5±0.5 | 2.8±0.4 | 0.001 |
Summary of findings
Plaque index (PI): There was a significant increase in PI scores for the fixed braces group at three months (2.3 ± 0.4) and six months (2.6 ± 0.5) compared to the clear aligners group at the same time points (1.5 ± 0.3 and 1.7 ± 0.4, respectively, P < 0.05).
Gingival index (GI): The GI scores showed a significant increase for patients with fixed braces at three months (1.8 ± 0.3) and six months (2.1 ± 0.4) compared to those with clear aligners (1.2 ± 0.2 and 1.3 ± 0.3, respectively, P < 0.05).
Probing depth (PD): Patients with fixed braces had significantly greater PD at three months (3.2 ± 0.5 mm) and six months (3.5 ± 0.5 mm) compared to the clear aligners group (2.7 ± 0.4 mm and 2.8 ± 0.4 mm, respectively, P < 0.05).
DISCUSSION
The current research compared the six-month periodontal health results of individuals using transparent aligners against fixed braces. Lower plaque index (PI), gingival index (GI), and probing depth (PD) scores at both three and six months showed that patients with transparent aligners had considerably improved periodontal health than those with fixed braces.
The intricate design of brackets and wires in permanent braces makes it more difficult for patients to maintain good oral hygiene habits, which contributes to an increase in plaque buildup. This result is in line with other research that found individuals using fixed orthodontic equipment had increased plaque levels.[1,2] On the other hand, patients may practice better dental hygiene since transparent aligners are removable, making it easier for them to brush and floss without difficulty.[3,4] The group’s lower gingival irritation and subsequent plaque buildup may be attributed to the aligners’ removable nature during mealtimes and cleaning.
Higher GI values in the fixed braces group suggested more severe gingival inflammation. This is consistent with previous research that indicates orthodontic equipment may worsen gingival inflammation by increasing the retention of plaque and making it more difficult to remove the plaque.[5,6] Conversely, the group that used transparent aligners showed less gingival inflammation as shown by their lower GI scores. This confirms earlier research that suggests, as compared to conventional braces, transparent aligners may be linked with better periodontal health results.[7,8,9]
Deeper probing depths are symptomatic of periodontal degeneration, which may be caused by persistent inflammation and plaque deposition. Probing depths were considerably higher in individuals with fixed braces at both three and six months.
CONCLUSION
This research concludes that, in comparison with fixed braces, transparent aligners are linked to superior periodontal health results. Patients who are worried about their periodontal health throughout orthodontic treatment may find that the transparent aligners group is a better choice because of the reduced levels of plaque formation, gingival irritation, and probing depths seen in this group.
Conflicts of interest
Nil.
Funding Statement
Nil.
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