Abstract
INTRODUCTION: With the wider therapeutic use of clear aligners the need to investigate the periodontal health status and microbiome of clear aligners’ patients in comparison with users of fixed orthodontic has arisen and is the objective of this thesis.
METHODS: A clinical periodontal evaluation was performed, followed by professional oral hygiene treatment on a patient under clear aligner treatment, another under fixed orthodontics and two controls that never received any orthodontic therapy. One week after, supragingival plaque, swabs from the orthodontic devices, and saliva samples were collected from each volunteer for further 16s sequencing and microbiome analysis.
RESULTS: All participants have overall good oral hygiene. However, our results showed increases in supragingival plaque, higher number of probing depths greater than 3mm, higher number of bleeding sites on probing, and a higher amount of gingival recession in the subject treated with fixed orthodontics. A lower bacterial count was observed colonizing the clear aligners, with less diversity than the other samples analyzed. Clear aligners exhibited a higher proportion of genus Porphyromona, which has a well-known periodontal pathogen, P. gingivalis. The genus Aggregatibacter had higher proportions on the subject with fixed orthodontics and the control with higher attachment loss. The species Aggregatibacter actinomycetemcomitans has been linked to aggressive forms of periodontal disease.
CONCLUSION: Clear aligners showed improved periodontal status indices when compared to fixed orthodontics. Overall, fewer bacteria were found on the clear aligner when compared to fixed orthodontics. Genera with known periodontal pathogens were found on both orthodontics devices.