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      Braces versus Invisalign®: gingival parameters and patients’ satisfaction during treatment: a cross-sectional study

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          Abstract

          Background

          Fixed orthodontic appliances (FOA) temporarily interfere with periodontal health of patients, as the appliance complicates oral hygiene. The use of aligners in orthodontic therapy increased strongly during the last decade. In the literature, the reports about effects of aligner treatment on oral hygiene and gingival conditions are scarce. This cross-sectional study evaluated oral hygiene and patient’s satisfaction during orthodontic treatment of patients with FOA or Invisalign®.

          Methods

          100 patients (FOA = 50, Invisalign® = 50) were included who underwent orthodontic treatment for more than 6 months. Clinical examinations were performed to evaluate patients’ periodontal condition and were compared with clinical data at the beginning of the orthodontic treatment. Oral hygiene, patients’ satisfaction and dietary habits were documented by a detailed questionnaire. For statistical analysis, the Mann–Whitney U-Test and Fisher’s Exact Test were used; as multiple testing was applied, a Bonferroni correction was performed.

          Results

          At the time of clinical examinations, patients with FOA were in orthodontic therapy for 12.9 ± 7.2 months, whereas patients with Invisalign® were in orthodontic therapy for 12.6 ± 7.4 months. Significantly better gingival health conditions were recorded in Invisalign® patients (GI: 0.54 ± 0.50 for FOA versus 0.35 ± 0.34 for Invisalign®; SBI: 15.2 ± 7.6 for FOA versus 7.6 ± 4.1 for Invisalign®), whereas the amount of dental plaque was also less but not significantly different (API: 37.7 % ± 21.9 for FOA versus 27.8 % ± 24.6 for Invisalign®). The evaluation of the questionnaire showed greater patients’ satisfaction in patients treated with Invisalign® than with FOA.

          Conclusion

          Patients treated with Invisalign® have a better periodontal health and greater satisfaction during orthodontic treatment than patients treated with FOA.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12903-015-0060-4) contains supplementary material, which is available to authorized users.

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          Most cited references19

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          PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION.

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            Prevalence of white spot lesions during orthodontic treatment with fixed appliances.

            To determine the prevalence of white spot lesions (WSLs) in orthodontic patients at 6 and 12 months into treatment using the visual examination method. Patients 6 and 12 months into treatment were examined for the presence of WSLs. The control group consisted of patients who were examined for WSLs immediately after bonding. Upon clinical evaluation, teeth were given a visual score based on the extent of demineralization. The percentages of individuals having at least one WSL were 38%, 46%, and 11% for the 6-month, 12-month, and control groups, respectively. The 6-month (P  =  .021) and 12-month groups (P  =  .005) were significantly different from the control group but were not significantly different from each other (P  =  .50). Of subjects in the study who had at least one visible WSL, 76% were males and 24% were females (P  =  .009). This clinical study showed a sharp increase in the number of WSLs during the first 6 months of treatment that continued to rise at a slower rate to 12 months. Clinicians should evaluate the oral hygiene status of patients during the initial months of treatment and, if necessary, should implement extra measures to prevent demineralization.
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              [Clinical methods for the objective evaluation of oral hygiene].

              Thus, it was the object of this investigation to test the common plaque indices with regard to their usuability and to compare them with a newly developed approximal space plaque index (API).
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                Author and article information

                Contributors
                +496131177246 , adrianoasso@hotmail.com
                jens.weusmann@unimedizin-mainz.de
                benjamin.mahmoodi@unimedizin-mainz.de
                kfo@peppas.de
                gerholda@uni-mainz.de
                cj.vannoorden@amc.uva.nl
                willersh@uni-mainz.de
                Journal
                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central (London )
                1472-6831
                24 June 2015
                24 June 2015
                2015
                : 15
                : 69
                Affiliations
                [ ]Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Augustusplatz 2, Mainz, 55131 Germany
                [ ]Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
                [ ]Private practice, Mainz, Germany
                [ ]Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University, Mainz, Germany
                Article
                60
                10.1186/s12903-015-0060-4
                4478712
                26104387
                b30bfc76-c11a-4c3d-a303-003056452e5f
                © Azaripour et al. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 11 February 2015
                : 16 June 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Dentistry
                aligner,foa,braces,dental hygiene,periodontal health
                Dentistry
                aligner, foa, braces, dental hygiene, periodontal health

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