Clear Aligners or Traditional Braces? An Effective Plan in the Ortho-Perio Treatment of Gingival Recessions

Gingival recession, a common clinical condition characterized by apical migration of the gingival margin, often presents in patients undergoing orthodontic treatment. Orthodontic forces can influence periodontal tissues positively or negatively, depending on the type of appliance used. The debate continues between clear aligners and traditional fixed braces concerning their effectiveness in managing such cases within interdisciplinary treatment plans.

A prospective, randomized clinical trial was conducted with 60 patients (30 per group) aged 20-35 years presenting with anterior gingival recession and mild-to-moderate malocclusion. Group A received treatment using clear aligners (Invisalign®), and Group B was treated with conventional metal brackets. Periodontal parameters, including gingival recession depth (GRD), clinical attachment level (CAL), and plaque index (PI), were recorded at baseline and after 12 months. Recession coverage was performed surgically at 6 months. Statistical analysis was conducted using paired t-tests and analysis of variance.

After 12 months, Group A showed significantly greater reduction in GRD (1.68 ± 0.39 mm) compared to Group B (1.21 ± 0.42 mm), P = 0.014. CAL gain was higher in Group A (1.91 ± 0.31 mm vs. 1.47 ± 0.37 mm; P = 0.026). PI scores were lower in the aligner group (P = 0.032). Both groups achieved recession coverage success above 80%, but Group A showed superior esthetic outcomes and patient compliance.

Clear aligners demonstrate a more favorable outcome in the interdisciplinary management of gingival recession when compared to traditional braces. They offer better plaque control, enhanced periodontal healing, and improved esthetics.