Periodontal status of adult patients treated with fixed buccal appliances and removable aligners over one year of active orthodontic therapy

Abstract

Objective: To compare the periodontal status of adults treated with fixed buccal orthodontic appliances vs removable orthodontic aligners over 1 year of active therapy.

Materials and methods: The study population consisted of 42 subjects; 22 treated with fixed buccal orthodontic appliances and 20 treated with removable aligners. Clinical indices recorded included: plaque index (PI), gingival index (GI), bleeding on probing (BOP), and probing pocket depth (PPD). Plaque samples were assessed for hydrolysis of N-benzoyl-DL-arginine-naphthylamide (BANA test). Indices and BANA scores were recorded before treatment and at 6 weeks, 6 months, and 12 months after initiation of orthodontic therapy.

Results: After 6 weeks, only mean PPD was greater in the fixed buccal orthodontic appliance group. However, after 6 months, the fixed buccal orthodontic appliance group had significantly greater mean PI, PPD, and GI scores and was 5.739 times more likely to have a higher BANA score. After 12 months, the fixed buccal orthodontic appliance group continued to have greater mean PI, GI, and PPD, while a trend was noted for higher BANA scores and BOP.

Conclusions: These results suggest treatment with fixed buccal orthodontic appliances is associated with decreased periodontal status and increased levels of periodontopathic bacteria when compared to treatment with removable aligners over the 12-month study duration.

Figures

Figure 1.

Effect of fixed buccal appliances vs removable aligners on PI after initiation of orthodontic therapy. Values are the mean ± standard error of the mean PI scores adjusted for differences in starting values for each subject using repeated measures ANCOVA. Significance of differences between fixed and removable groups at 6 weeks, P  =  .078; 6 months, P

Figure 2.

Effect of fixed buccal appliances vs removable aligners on GI after initiation of orthodontic therapy. Values are the mean ± standard error of the mean GI scores adjusted for differences in starting values for each subject using repeated measures ANCOVA. Significance of differences between fixed and removable groups at 6 weeks, P  =  .126; 6 months, P

Figure 3.

Effect of fixed buccal appliances vs removable aligners on BOP after initiation of orthodontic therapy. Values are the mean ± standard error of the mean BOP scores adjusted for differences in starting values for each subject using repeated measures ANCOVA. Significance of differences between fixed and removable groups at 6 weeks, P  =  .645; 6 months, P

Figure 4.

Effect of fixed buccal appliances vs removable aligners on PPD after initiation of orthodontic therapy. Values are the mean ± standard error of the mean probing pocket depth adjusted for differences in starting values for each subject using repeated measures ANCOVA. Significance of differences between fixed and removable groups at 6 weeks, P  =  .012; 6 months, P