ArticleCureus2025
Comparative Evaluation of Periodontal Pathogen Load and Health in Patients Treated With Fixed Orthodontic Appliances Versus Clear Aligners: A Prospective Clinical Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
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Abstract
introductionOrthodontic appliances can alter the oral microbial ecosystem and predispose patients to plaque accumulation and periodontal inflammation. Fixed appliances introduce bracket-wire complexes that favor biofilm retention, whereas clear aligners are removable and may allow better maintenance of oral hygiene. This study aimed to compare short-term changes in clinical periodontal parameters and subgingival colonization by MATERIALS AND
methodsThis prospective study was conducted in the Department of Orthodontics, where 40 healthy adults aged 18-30 years were enrolled and equally divided into two groups: fixed appliances (n=20) and clear aligners (n=20). Baseline professional prophylaxis was administered to all patients before appliance placement. Clinical assessments, including plaque index, bleeding on probing, and probing depth, were recorded at baseline (T0) and after three months (T1). Subgingival plaque samples were collected from the second premolars and lateral incisors, and bacterial loads of
resultsAt baseline, the two groups were comparable with no significant differences in clinical parameters or microbial counts. After three months, the fixed appliance group showed significantly greater deterioration in periodontal parameters than the clear aligner group. The mean increase in plaque index was 0.54±0.26 for fixed appliances versus 0.20±0.16 for clear aligners (p<0.001). Bleeding on probing and probing depth also worsened in the fixed appliance group. Microbiological analysis revealed higher bacterial loads for both pathogens in the fixed appliance group. Median
conclusionFixed orthodontic appliances were associated with significantly greater increases in periodontopathogen loads and deterioration in periodontal health during the early treatment period than clear aligners. Therefore, clear aligners may be a more favorable option for patients in whom periodontal preservation is a priority.
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