A Comparison of the Periodontal Health of Patients during Treatment with the Invisalign® System and with Fixed Orthodontic Appliances

Abstract Objective: Evaluation of the periodontal health in patients during treatment with either fixed orthodontic appliances or the Invisalign^® system. Study Design: The study was designed as a concomitant trial. The evaluation of the patients started in February 2002 and was completed in August 2003. Patients and Methods: Thirty consecutive patients each with fixed orthodontic appliances and with aligners were examined at three consecutive control visits for their periodontal condition. All individuals were part of the clientele of the Department of Orthodontics and Dentofacial Orthopedics of the Charité Berlin. The parameters evaluated were the modified Gingival Index, modified Plaque Index, modified Papillary Bleeding Index, and sulcus probing depth. The first three indices were recorded alternatively buccally and lingually in all permanent teeth from central incisor to first molar: buccally in the maxillary right and the mandibular left quadrants, lingually in the maxillary left and mandibular right quadrants. The sulcus depth was measured in four areas: mesially and distally, lingually and buccally in the 1st molar and the 1st premolar of each quadrant. Each control visit was concluded with a detailed, individualized oral hygiene instruction. Results: The modified Plaque Index was significantly lower in the Invisalign^® group overall. On the other hand, the periodontal condition of the two samples was nearly identical. Conclusion: Periodontal health is not jeopardized, even though the Invisalign^® system aligners cover all the teeth and the keratinized gingiva in part. This could be attributed to the fact that aligners are removable and thus allow unimpeded oral hygiene.