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Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances

Parodontale Gesundheit von Teenagern mit herausnehmbaren Alignern und festsitzenden kieferorthopädischen Apparaturen

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Objectives

The purpose of this study was to explore the microbiological and periodontal changes occurring in adolescents during 12 months of orthodontic therapy with removable aligners and with fixed appliances.

Material and methods

During the years 2012–2013, 50 teenagers aged 10–18 years with similar initial orthodontic conditions participated in this trial in a university clinic in northern Italy. After receiving professional oral hygiene and instructions on a standardized oral hygiene protocol, the adolescents were randomly assigned to either orthodontic treatment with traditional fixed brackets (n = 25) or to treatment with Invisalign® aligners (n = 25). Subgingival microbiological samples, probing depth (PD), plaque index (PI), and bleeding on probing (BOP) were obtained and documented from the mesiovestibular subgingival sulcus of the upper right first molar and left central incisor at the beginning of treatment and 3, 6, and 12 months later. Compliance with oral hygiene procedures, full mouth plaque score (FMPS), and full mouth bleeding score (FMBS) were assessed at the beginning of treatment and 12 months later. Two sample independent t-tests and the χ2 test were used to study whether the indices of periodontal health differed in the teenagers due to the experimental conditions.

Results

None of the patients was positive for the periodontal anaerobes analyzed. The PI, PD, BOP, FMPS, and FMBS scores were significantly lower and compliance with oral hygiene was significantly higher in the group treated with Invisalign® than in the group treated with fixed brackets.

Conclusion

Teenagers treated with removable appliances display better compliance with oral hygiene, less plaque, and fewer gingival inflammatory reactions than their peers with fixed appliances.

Zusammenfassung

Studienziel

Gegenstand dieser Untersuchung waren die mikrobiologischen und parodontalen Veränderungen bei Jugendlichen über 12 Behandlungsmonate mit herausnehmbaren Alignern oder festsitzenden Apparaturen.

Methode

Die Studie umfasst 50 Teenager (10–18 Jahre) mit vergleichbaren kieferorthopädischen Indikationen, behandelt in den Jahren 2012 und 2013 an einer norditalienischen Universitätsklinik. Nach einer professionellen Hygienesitzung und Unterweisung in einem standardisierten Mundhygieneverfahren erfolgte nach dem Zufallsprinzip die Zuordnung der Jugendlichen zu einer von 2 Behandlungsgruppen mit traditionellen Klebebrackets (n = 25) oder Invisalign®-Schienen (n = 25). Zu Behandlungsbeginn sowie 3, 6 und 12 Monate danach erfolgten mikrobiologische Probenentnahmen im Oberkiefer aus dem mesiovestibulären Sulkusbereich des rechten ersten Molaren und linken mittleren Schneidezahns sowie eine Beurteilung auf Sondiertiefen, Plaqueindex und provozierte Blutungen. Außerdem beurteilten wir zu Behandlungsbeginn und 12 Monate danach die Hygienedisziplin sowie die Gesamtindizes FMPS (Full Mouth Plaque Score) und FMBS (Full Mouth Bleeding Score). Zweistichproben-t-Tests für unabhängige Stichproben und der χ2-Test dienten dem Auffinden von Gruppenunterschieden bei den parodontalen Indizes.

Resultate

Tests auf 4 anaerobe Parodontalkeime waren für alle Patienten negativ. Die Invisalign®-Gruppe zeigte gegenüber der Bracket-Gruppe signifikant niedrigere Werte für Plaqueindex, Sondiertiefen, provozierte Blutungen sowie FMPS- und FMBS-Werte. Auch die Hygienedisziplin war in der Invisalign®-Gruppe signifikant besser.

Schlussfolgerung

Im Vergleich zu Gleichaltrigen mit festsitzenden Apparaturen zeigten die mit herausnehmbaren Aligners behandelten Teenager eine bessere Hygienedisziplin sowie weniger Plaque und Entzündungsreaktionen.

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Acknowledgments

The authors wish to acknowledge Dr. Federico Migliori (Department of Orthodontics, University of Insubria, Varese Italy) and Dr. Silvia Margherini (Department of Oral Hygiene, University of Insubria, Varese Italy) for their valuable contribution in data collection.

Danksagung

Die Autoren danken Dr. Federico Migliori (Abteilung für Kieferorthopädie, Universität Insubria, Varese, Italien) und Dr. Silvia Margherini (Abteilung für Oralhygiene, Universität Insubria) für ihre wertvolle Mitwirkung bei der Datenerhebung.

Compliance with ethical guidelines

Conflict of interest. G.M. Abbate, M.P. Caria, P. Montanari, C. Mannu, G. Orrù, A. Caprioglio, and L. Levrini state that there are no conflicts of interest.

All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

Einhaltung ethischer Richtlinien

Interessenkonflikt. G.M. Abbate, M.P. Caria, P. Montanari, C. Mannu, G. Orrù, A. Caprioglio und L. Levrini geben an, dass kein Interessenkonflikt besteht.

Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Authors and Affiliations

  1. Faculty of Dentistry and Oral Hygiene, University of Insubria, Via Piatti 10, 21100, Varese, Italy

    G.M. Abbate & L. Levrini

  2. Department of Public Health Sciences, Karolinska Institutet, Widerströmska Huset, Stockholm, Sweden

    M.P. Caria

  3. Department of Orthodontics, Faculty of Dentistry, University of Insubria, Varese, Italy

    P. Montanari & A. Caprioglio

  4. O. B. L. Department of Surgical Sciences, University of Cagliari, Cagliari, Italy

    C. Mannu & G. Orrù

Authors
  1. G.M. Abbate
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  2. M.P. Caria
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  3. P. Montanari
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  4. C. Mannu
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  5. G. Orrù
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  7. L. Levrini
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Correspondence to G.M. Abbate.

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Abbate, G., Caria, M., Montanari, P. et al. Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances. J Orofac Orthop 76, 240–250 (2015). https://doi.org/10.1007/s00056-015-0285-5

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  • DOI: https://doi.org/10.1007/s00056-015-0285-5

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