Impact of Clear Aligners versus Fixed Appliances on Periodontal Status of Patients Undergoing Orthodontic Treatment: A Systematic Review of Systematic Reviews

Abstract

The present umbrella review of four systematic reviews with meta-analysis aimed to assess whether clear aligners are associated with better periodontal conditions compared with fixed appliances in patients undergoing orthodontic treatment. The present study protocol was developed in accordance with the PRISMA statement before the literature search, data extraction, and analysis and was registered on PROSPERO (CRD42023401808). The question formulation, search, and study selection strategies were developed according to the PICO model. Systematic reviews with a meta-analysis published in English without date restriction were electronically searched across the Cochrane Library, Web of Science (Core Collection), Scopus, EMBASE, and MEDLINE/PubMed databases until 10 February 2023. An assessment of study quality was performed using the AMSTAR 2 tool. Differences in the PI, GI, and BOP in the short- and medium-term follow-ups, in the PPD in long-term follow-up, and the gingival recessions in the short-term follow-up were found between subjects with clear aligners and fixed appliances, revealing a slight tendency for clear aligners to be associated with healthier periodontal conditions. However, even if statistically significant, such differences would be negligible in a clinical environment. Therefore, the impact of orthodontic treatment with clear aligners and fixed appliances on periodontal health status should be considered comparable.

Preformed Elastodontic Appliances: Awareness and Attitude of Orthodontists and General Dental Practitioners

“…Interestingly, most practitioners reported that the capability to maintain oral hygiene of patients undergoing treatment with EAs and fixed orthodontic treatment was comparable. These data are inconsistent with the common belief that since removable appliances can be easily removed during meals and oral hygiene procedures, they allow patients to effectively control oral biofilm and plaque accumulation [29], emphasizing the importance of oral hygiene motivation regardless of the type of orthodontic treatment [30,31].…”

Maxillary Impacted Canine and Upper Lateral Incisor Agenesis Treatment with “Canine First Technique” and Clear Aligners: A Case Report

“…The use of clear aligners provides several advantages, including aesthetics, comfort, better control of oral hygiene and precise tooth movement compared to traditional fixed orthodontic appliances [ 1 , 24 , 25 , 26 , 27 ].…”

Clear Aligners in the Growing Patient: A Systematic Review

“…These studies contribute to understanding the evolving paradigm of orthodontic care, emphasizing the intricate interplay between orthodontic treatments and gingival or periodontal health. Clear aligners, such as the Invisalign First System, not only serve as tools for achieving dental aesthetics but also potentially contribute to improved periodontal well-being compared to traditional fixed appliances [71].…”