Braces versus Invisalign®: gingival parameters and patients' satisfaction during treatment: a cross-sectional study
A Azaripour, J Weusmann, B Mahmoodi, D Peppas, A Gerhold-Ay, C J F Van Noorden, B Willershausen, A Azaripour, J Weusmann, B Mahmoodi, D Peppas, A Gerhold-Ay, C J F Van Noorden, B Willershausen
Abstract
Background: Fixed orthodontic appliances (FOA) temporarily interfere with periodontal health of patients, as the appliance complicates oral hygiene. The use of aligners in orthodontic therapy increased strongly during the last decade. In the literature, the reports about effects of aligner treatment on oral hygiene and gingival conditions are scarce. This cross-sectional study evaluated oral hygiene and patient's satisfaction during orthodontic treatment of patients with FOA or Invisalign®.
Methods: 100 patients (FOA = 50, Invisalign® = 50) were included who underwent orthodontic treatment for more than 6 months. Clinical examinations were performed to evaluate patients' periodontal condition and were compared with clinical data at the beginning of the orthodontic treatment. Oral hygiene, patients' satisfaction and dietary habits were documented by a detailed questionnaire. For statistical analysis, the Mann-Whitney U-Test and Fisher's Exact Test were used; as multiple testing was applied, a Bonferroni correction was performed.
Results: At the time of clinical examinations, patients with FOA were in orthodontic therapy for 12.9 ± 7.2 months, whereas patients with Invisalign® were in orthodontic therapy for 12.6 ± 7.4 months. Significantly better gingival health conditions were recorded in Invisalign® patients (GI: 0.54 ± 0.50 for FOA versus 0.35 ± 0.34 for Invisalign®; SBI: 15.2 ± 7.6 for FOA versus 7.6 ± 4.1 for Invisalign®), whereas the amount of dental plaque was also less but not significantly different (API: 37.7 % ± 21.9 for FOA versus 27.8 % ± 24.6 for Invisalign®). The evaluation of the questionnaire showed greater patients' satisfaction in patients treated with Invisalign® than with FOA.
Conclusion: Patients treated with Invisalign® have a better periodontal health and greater satisfaction during orthodontic treatment than patients treated with FOA.
References
- Zachrisson S, Zachrisson BU. Gingival condition associated with orthodontic treatment. Angle Orthodontist. 1972;42(1):26–34.
- Tufekci E, Dixon JS, Gunsolley JC, Lindauer SJ. Prevalence of white spot lesions during orthodontic treatment with fixed appliances. Angle Orthodontist. 2011;81(2):206–10. doi: 10.2319/051710-262.1.
- Huser MC, Baehni PC, Lang R. Effects of orthodontic bands on microbiologic and clinical parameters. Am J Orthod Dentofac Orthop. 1990;97(3):213–8. doi: 10.1016/S0889-5406(05)80054-X.
- Attin R, Thon C, Schlagenhauf U, Werner C, Wiegand A, Hannig C, et al. Recolonization of mutans steptococci on teeth with orthodontic appliances after antimicrobial therapy. Eur J Orthod. 2005;27(5):489–93. doi: 10.1093/ejo/cji018.
- Gusberti FA. Clinical and microbiological periodontal aspects in orthodontic treatments. Schweizerische Monatsschrift für Zahnmedizin. 1984;94(5):462–8.
- Harzer W, Staegemann EM. Effect of removable and fixed orthodontic appliances on the marginal periodontium. Stomatologie der DDR. 1986;36(11):648–51.
- Miethke RR, Vogt S. A comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed orthodontic appliances. J Orofac Orthop. 2005;66(3):219–29. doi: 10.1007/s00056-005-0436-1.
- Miethke RR, Brauner K. A comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed lingual appliances. J Orofac Orthop. 2007;68(3):223–31. doi: 10.1007/s00056-007-0655-8.
- Lange DE, Plagmann HC, Eenboom A, Promesberger A. Clinical methods for the objective evaluation of oral hygiene. Deutsche zahnarztliche Zeitschrift. 1977;32(1):44–7.
- Silness J, Löe H. Periodontal disease in pregancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22:121–35. doi: 10.3109/00016356408993968.
- Attin R. Introduction of a new plaque index designed for control and motivation of orthodontic patients. Informationen aus Orthodontie Kieferorthopädie. 2005;37(04):271–3. doi: 10.1055/s-2005-918210.
- Balenseifen JW, Madonia JV. Study of dental plaque in orthodontic patients. J Dent Res. 1970;49(2):320–4. doi: 10.1177/00220345700490022101.
- Heintze SD, Jost-Brinkmann PG, Loundos J. Effectiveness of three different types of electric toothbrushes compared with a manual technique in orthodontic patients. Am J Orthod Dentofac Orthop. 1996;110(6):630–8. doi: 10.1016/S0889-5406(96)80040-0.
- Karkhanechi M, Chow D, Sipkin J, Sherman D, Boylan RJ, Norman RG, et al. Periodontal status of adult patients treated with fixed buccal appliances and removable aligners over one year of active orthodontic therapy. Angle Orthodontist. 2013;83(1):146–51. doi: 10.2319/031212-217.1.
- Hickman J, Millett DT, Sander L, Brown E, Love J. Powered vs manual tooth brushing in fixed appliance patients: a short term randomized clinical trial. Angle Orthodontist. 2002;72(2):135–40.
- Borutta A, Pala E, Fischer T. Effectiveness of a powered toothbrush compared with a manual toothbrush for orthodontic patients with fixed appliances. J Clin Dent. 2002;13(4):131–7.
- Deery C, Heanue M, Deacon S, Robinson PG, Walmsley AD, Worthington H, et al. The effectiveness of manual versus powered toothbrushes for dental health: a systematic review. J Dent. 2004;32(3):197–211. doi: 10.1016/j.jdent.2003.11.006.
- Sergl HG, Klages U, Zentner A. Functional and social discomfort during orthodontic treatment–effects on compliance and prediction of patients’ adaptation by personality variables. Eur J Orthod. 2000;22(3):307–15. doi: 10.1093/ejo/22.3.307.
- Bernabe E, Sheiham A, de Oliveira CM. Impacts on daily performances related to wearing orthodontic appliances. Angle Orthodontist. 2008;78(3):482–6. doi: 10.2319/050207-212.1.
Source: PubMed