Partouche Aaron Jacob David, Castro Filipe, Baptista Ana Sofia, Costa Liliana Gavinha, Fernandes Juliana Campos Hasse, Fernandes Gustavo Vicentis de Oliveira
FP-I3ID, FSC, Universidade Fernando Pessoa, 4249-004 Porto, Portugal.
Cooperativa de Ensino Superior, Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal.
Dent J (Basel). 2022 Sep 21;10(10):177. doi: 10.3390/dj10100177.
: This integrative review aimed to identify studies comparing the periodontal health in patients wearing multibracket orthodontic appliances and clear aligners. : An integrative literature search was performed through different databases, PubMed/Medline, PMC, and the Cochrane Library. This work was submitted to a search strategy following the PICO method and included the focus question: "Could the chosen orthodontic appliance change significantly the oral hygiene of the patient, impairing the periodontal health?" This work included analytical and controlled studies on humans published between 2005 and 2020, in the English language, establishing a comparison of the periodontal status in patients undergoing orthodontic multibracket and clear aligners therapies. The main periodontal indexes assessed were plaque index (PI), pocket depth (PD), gingival index (GI), and bleeding on probing (BoP). : The electronic research displayed 386 articles on PMC, 106 on PubMed, and 40 on the Cochrane Library. After removal, just 25 articles were selected for full-text screening, but just eight studies were eligible for this integrative review. It was enumerated that 204 patients were treated with aligners and 294 with multibracket orthodontic appliances, mainly elastomeric ligated brackets. Only the plaque index displayed a significant difference between the two groups and general data obtained showed a better control for periodontal health in the clear aligners. Limitations such as age, malocclusion severity, therapeutic choice, and different time measure was observed. In addition, the oral hygiene instruction and follow-up by a professional were different, and the role of malocclusion was not present in the studies. : Within the limitations of this study, better results for periodontal health were found in the clear aligners. Therefore, more studies are necessary to affirm that aligners are synonymous with better gingival conditions in comparison with multibracket appliances. Other variables such as oral hygiene instructions, motivation, and supportive treatment tend to be more prevalent than the type of appliance itself in the periodontal evaluation.
本系统综述旨在确定比较佩戴多托槽正畸矫治器和隐形矫治器患者牙周健康状况的研究。通过不同数据库（PubMed/Medline、PMC和Cochrane图书馆）进行了系统文献检索。本研究按照PICO方法制定检索策略，重点问题为：“所选正畸矫治器是否会显著改变患者的口腔卫生状况，损害牙周健康？”本研究纳入了2005年至2020年间发表的关于人类的分析性和对照性研究，这些研究采用英文撰写，比较了接受多托槽正畸和隐形矫治治疗的患者的牙周状况。评估的主要牙周指标包括菌斑指数（PI）、牙周袋深度（PD）、牙龈指数（GI）和探诊出血（BoP）。电子检索在PMC上显示386篇文章，在PubMed上显示106篇，在Cochrane图书馆上显示40篇。剔除后，仅25篇文章被选进行全文筛选，但只有8项研究符合本系统综述的要求。结果表明，204例患者接受了隐形矫治治疗，294例患者接受了多托槽正畸矫治，主要是弹性结扎托槽。两组之间仅菌斑指数存在显著差异，总体数据显示隐形矫治对牙周健康的控制更好。研究观察到了年龄、错牙合严重程度、治疗选择和不同时间测量等局限性。此外，专业人员的口腔卫生指导和随访也不同，且研究中未涉及错牙合的作用。在本研究的局限性范围内，发现隐形矫治在牙周健康方面有更好的结果。因此，需要更多研究来证实与多托槽矫治器相比，隐形矫治意味着更好的牙龈状况。在牙周评估中，口腔卫生指导、动机和支持性治疗等其他变量往往比矫治器类型本身更普遍。
