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MAINZ, Germany: In recent years, clear aligners have become a favourable treatment alternative in orthodontics to fixed orthodontic appliances (FOA). However, there are few studies about the effects of aligner treatment on oral hygiene and gingival condition. A team of German researchers has now compared the oral health status, oral hygiene and treatment satisfaction of patients treated with FOA and the Invisalign aligner system. They found that Invisalign patients have better periodontal health and greater satisfaction during orthodontic treatment.
To date, the majority of patients, particularly during childhood and adolescence, are treated with FOA. However, these appliances tend to complicate oral hygiene and thus interfere with patients’ periodontal health. Moreover, treatment with FOA is not very popular in adult orthodontics for aesthetic reasons. Therefore, other orthodontic techniques have been developed to improve aesthetics and simplify oral hygiene procedures. An alternative to FOA is clear aligners, which are discreet and have the advantage of being removable during oral hygiene and eating or drinking. The use of clear aligners has increased greatly in the last decade, one prominent example being Invisalign, produced by Align Technology since 1999. However, only a limited number of studies have compared the effects of Invisalign and FOA on oral hygiene, the researchers from the Johannes Gutenberg University of Mainz pointed out.
Their study included 100 patients who underwent orthodontic treatment, divided equally between FOA and Invisalign, for more than six months. The researchers performed clinical examinations before and after treatment to evaluate the patients’ periodontal condition and any changes. Furthermore, a detailed questionnaire assessed the patients’ personal oral hygiene and dietary habits, as well as satisfaction with the treatment. All of the patients received the same oral hygiene instructions before and during orthodontic treatment. This included the use of toothbrush, dental floss and interdental brushes three times daily.
The data analysis showed no differences between the two groups regarding periodontal health and oral hygiene prior to the orthodontic treatment. However, the researchers observed notable changes in periodontal condition in both groups during orthodontic treatment. They found that gingival health was significantly better in patients treated with Invisalign, and the amount of dental plaque was also less but not significantly different compared with FOA patients.
The questionnaire results showed greater satisfaction in patients treated with Invisalign. Only 6 per cent of the Invisalign patients reported impairment of their general well-being during orthodontic treatment, compared with 36 per cent of the FOA patients. Other negative effects that also were significantly higher in FOA patients included gingival irritation (FOA: 56 per cent; Invisalign: 14 per cent), being kept from laughing for aesthetic reasons (FOA: 26 per cent; Invisalign: 6 per cent), having to change eating habits during orthodontic treatment (FOA: 70 per cent; Invisalign: 50 per cent), and having to brush one’s teeth for longer and more often (FOA: 84 per cent; Invisalign: 52 per cent).
The researchers concluded that orthodontic treatment with Invisalign has significantly lower negative impacts on a patient’s condition than treatment with FOA, both with regard to gingival health and overall well-being.
The study, titled “Braces versus Invisalign: Gingival parameters and patients’ satisfaction during treatment: A cross-sectional study”, was published online in the BMC Oral Health journal on 24 June.
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