Braces Versus Invisalign®: Gingival Parameters and Patients' Satisfaction During Treatment: A Cross-sectional Study

A. Azaripour; J. Weusmann; B. Mahmoodi; D. Peppas; A. Gerhold-Ay; C. J. F. Van Noorden; B. Willershausen


BMC Oral Health. 2015;15(69) 

In This Article


Fixed orthodontic appliances (FOA) promote the accumulation of bacterial plaque because FOA limit the ability of patients to perform good oral hygiene, which can lead to temporary destructive periodontal processes.[1–4] Deterioration of the periodontal status and dental decalcification during orthodontic treatment can be avoided only when the patient is incorporated in a stringent recall system.[5,6]

In the majority of patients, particularly during childhood and adolescence, FOA are the treatment of choice. Because of esthetics reasons, this treatment is not very popular for adult orthodontics. Therefore, other orthodontic techniques have been developed to increase esthetics and simplify oral hygiene procedures.

An alternative for FOA is Invisalign® which has been available since 1999 and offers not only the advantage of better esthetics but also the convenience of removal during food and beverage consumption, as well as oral care.

The Invisalign® system is a relatively novel treatment method and only a limited number of studies is available that compare effects of Invisalign® and FOA on oral hygiene. Miethke et al.[7,8] showed that patients treated with Invisalign® do not have an increased periodontal risk, although both teeth and gingiva were covered nearly the entire day with aligners. It indicates that patients using the Invisalign® system have a better periodontal health as compared to FOA-treated patients.

The aim of the present study was to compare oral health status, oral hygiene and patients satisfaction during orthodontic treatment of patients with FOA and Invisalign®.

The primary hypothesis of this study was that Invisalign® patients have better oral hygiene and gingival inflammation parameters than FOA patients. Second hypothesis was that Invisalign® is associated with a better quality of life during orthodontic treatment than FOA.