Orthodontic Treatment with Fixed Appliances Versus Aligners: An Experimental Study of Periodontal Aspects

Objective: This study aimed to compare the effects of orthodontic treatment on the same patients using aligners (upper arch) versus traditional fixed appliances (lower arch) on oral hygiene and periodontal health. Materials and Methods: A total of 90 patients, all treated by the same orthodontist and with an average age of 26 years, were included in the study. The research focused on factors predisposing patients to periodontitis, as well as plaque and tartar accumulation. Statistical analysis was performed using the paired-samples Student's t-test, with values of p < 0.05 deemed statistically significant. Results: Patients treated with fixed orthodontic appliances generally showed increased plaque accumulation (+10% PI) and a decline in periodontal health compared to those treated with aligners (40% presented a high level of S.Mutans and Lactobacilli). In patients who did not maintain proper oral hygiene, the initial conditions of the upper arch remained stable, while the lower arch exhibited significant deterioration, with increased plaque buildup and greater tissue inflammation. Conclusions: The findings emphasize the critical role of individual oral hygiene practices during orthodontic treatment in preserving periodontal health. Aligners appear to be more favorable in protecting periodontal tissues, improving plaque control, and reducing gingival inflammation. Various supplementary approaches for plaque management and microbial colonization in saliva should be implemented based on the type of orthodontic appliance used.