Impact of Clear Aligners vs Conventional Brackets on Oxidant and Antioxidant Levels: A Case-Control Study

BACKGROUND The aim of this study was to identify the changes in the levels of total oxidant status (TOS) and total antioxidant status (TAS) in gingival crevicular fluid (GCF) samples of patients treated with conventional brackets (CBs) and clear aligners (CAs) over a 30-day period. MATERIAL AND METHODS Thirty-four patients who received non-extraction treatment with either CBs or CAs were included in the study. GCF samples were obtained at baseline (T0) and on days 7 (T1) and 30 (T2) following initial phase of treatment. Clinical periodontal parameters were used to determine periodontal conditions of patients. ELISA method was used to determine TAS and TOS levels in GCF samples. RESULTS In the group treated with CAs, TOS levels in GCF were significantly high at T1 but approached T0 after the first month (T2) of treatment. In contrast, the group treated with CBs showed significantly high TOS levels in GCF at both T1 and T2 compared with T0. No significant changes were observed in GCF TAS data at T1 and T2 in either group (CA and CB), compared with T0. When comparing TOS data between the groups at T1 and T2, the CA group had lower TOS levels than the CB group (Mann-Whitney U with Bonferroni correction). Additionally, the CA group had lower periodontal clinical indexes than did the CB group. CONCLUSIONS Oxidative tissue damage during orthodontic teeth movements may be lower with CA treatment. In cases in which higher oxidative stress is anticipated, CA treatment may be preferred over CB treatment.