Evaluation of Oral Hygiene Status in Patients Using Clear Aligners Versus Fixed Orthodontic Appliances
DOI:
https://doi.org/10.48165/ajm.2026.9.01.9Keywords:
Clear aligners, fixed orthodontic appliances, oral hygiene, plaque index, gingival indexAbstract
Background:Orthodontic appliances can adversely affect oral hygiene by promoting plaque accumulation and gingival inflammation. Fixed orthodontic appliances are associated with increased plaque-retentive areas, whereas clear aligners, being removable, may facilitate better oral hygiene maintenance. Aim:To evaluate and compare the oral hygiene status in patients undergoing orthodontic treatment with clear aligners and fixed orthodontic appliances. Materials and Methods:A comparative clinical study was conducted on 60 orthodontic patients divided into two groups: Group A comprised 30 patients treated with clear aligners, and Group B comprised 30 patients treated with fixed orthodontic appliances. Oral hygiene status was assessed using the Plaque Index (Silness and Löe) and Gingival Index (Löe and Silness). The collected data were statistically analyzed using the independent t-test. Results:The mean plaque and gingival index scores were significantly lower in the clear aligner group compared to the fixed appliance group (p < 0.05), indicating superior oral hygiene and gingival health among aligner-treated patients. Conclusion: Patients treated with clear aligners demonstrated better oral hygiene status than those treated with fixed orthodontic appliances. Clear aligners may therefore be considered a favorable treatment option for patients where maintenance of periodontal health is a priority.Downloads
References
AlMogbel, A. (2023). Clear aligner therapy: Up-to-date review article. Journal of Orthodontic Science, 12, 37. https://doi.org/10.4103/jos.jos_37_23
Cerroni, S., Pasquantonio, G., Condò, R., & Cerroni, L. (2018). Orthodontic fixed appliance and periodontal status: An updated systematic review. Open Dentistry Journal, 12, 614–622. https://doi.org/10.2174/1874210601812010614
Giannini, L., Galbiati, G., Tartaglia, F. C., Grecolini, M. E., Maspero, C., & Biagi, R. (2025). Orthodontic treatment with fixed appliances versus aligners: An experimental study of periodontal aspects. Dentistry Journal, 13(2), 70. https://doi.org/10.3390/dj13020070
Jaber, S. T., Hajeer, M. Y., & Sultan, K. (2023). Treatment effectiveness of clear aligners in correcting complicated and severe malocclusion cases compared to fixed orthodontic appliances: A systematic review. Cureus, 15, e38311. https://doi.org/10.7759/cureus.38311
Jamilian, A., Kiaee, B., Sanayei, S., Khosravi, S., & Perillo, L. (2016). Orthodontic treatment of malocclusion and its impact on oral health-related quality of life. Open Dentistry Journal, 10, 236–241. https://doi.org/10.2174/1874210601610010236
Löe, H., & Silness, J. (1963). Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontologica Scandinavica, 21, 533–551. https://doi.org/10.3109/00016356308977846
Miethke, R. R., & Brauner, K. (2007). A comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed orthodontic appliances. Journal of Orofacial Orthopedics, 68, 223–231. https://doi.org/10.1007/s00056-007-0064-3
Miethke, R. R., & Vogt, S. (2005). A comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed orthodontic appliances. Journal of Orofacial Orthopedics, 66, 219–229. https://doi.org/10.1007/s00056-005-0184-1
Partouche, A. J. D., Castro, F., Baptista, A. S., Costa, L. G., Fernandes, J. C. H., & Fernandes, G. V. O. (2022). Effects of multi-bracket orthodontic treatment versus clear aligners on periodontal health: An integrative review. Dentistry Journal, 10, 177. https://doi.org/10.3390/dj10050177
Almutairi, R. M., Alturaif, D. J., & Alanzi, L. M. (2023). Importance of oral hygiene in orthodontic treatment. Saudi Journal of Oral and Dental Research, 8(3), 100–109. https://doi.org/10.36348/sjodr.2023.v08i03.001
Silness, J., & Löe, H. (1964). Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontologica Scandinavica, 22, 121–135. https://doi.org/10.3109/00016356408993993
Tuncer, A. V., & Baylas, H. (1990). Examination of the effects of various orthodontic appliances on periodontal tissues. Turkish Journal of Orthodontics, 3, 13–18.
