Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.01624
Revista de Odontologia da UNESP
Original Article

Periodontal monitoring in orthodontic treatment with orthodontic aligners: proof of concept

Acompanhamento periodontal em tratamento com alinhadores ortodônticos: prova de conceito

Yasmin Dallarmi MIGUEL; Paola Rebelatto ALCÂNTARA; Ana Cláudia Moreira Melo TOYOFUKU; Roberto Hideo SHIMIZU

http://dx.doi.org/10.1590/1807-2577.01624 Rev. odontol. UNESP, vol.53, e20240016, 2024
PDF
Downloads: 0
Views: 59

Abstract

Introduction: The impact of aligners in the periodontal conditions and protocols for hygiene were investigated.

Objective: This study assessed the periodontal condition of patients undergoing orthodontic treatment with ClearCorrect aligners and compare periodontal health conditions after the use of BlueM mouthwash and foam as clinical protocols for oral and aligner hygiene.

Material and method: In 16 patients’ treatment was performed using aligners, and a periodontal follow-up was conducted. The sample was divided into 3 randomized groups: Control, Mouthwash, and Foam, with each patient passing through all groups. The use of a standardized toothpaste was indicated. A periodontal examination was performed on baseline and every 2 months using gingival sulcus probing, insertion level, recession, bleeding on probe index, and biofilm presence.

Result: Significant differences were observed in distal probing of the teeth when comparing baseline and the mouthwash group in the intergroup analysis, irrespective of the side of the mouth and the tooth evaluated. When assessing bleeding on probe, baseline showed 1.8 times more risk of bleeding on probe than foam, 1.9 times more risk than the control, and 2.4 times more than mouthwash group. Regarding biofilm presence, baseline data showed 1.4 times more risk of having biofilm than foam, and 1.9 times more risk than mouthwash groups. In relation to the control, there was no statistically significant difference.

Conclusion: Patients when using BlueM mouthwash had a lower chance of bleeding on probe and presence of biofilm, as well as an improvement in distal periodontal probing depth when compared to baseline situation.

Keywords

ClearCorrect aligners; periodontal health; BlueM mouthwash; BlueM foam; orthodontic treatment

Resumo

Introdução: O impacto dos alinhadores nas condições periodontais e protocolos clínicos de higiene têm sido investigados.

Objetivo: Este estudo teve como objetivo avaliar a condição periodontal de pacientes em tratamento ortodôntico com alinhadores ClearCorrect e comparar as condições de saúde periodontal após o uso do enxaguatório bucal BlueM e da espuma BlueM como protocolos clínicos para higiene oral e de alinhadores.

Material e método: Em 16 pacientes, o tratamento ortodôntico foi realizado utilizando alinhadores, e foi conduzido um acompanhamento periodontal. A amostra de pacientes foi dividida em 3 grupos randomizados: Controle, Enxaguatório e Espuma, com cada paciente passando por todos os três grupos. Todos os pacientes receberam instruções para limpar os alinhadores com água e escova de dentes. O uso de uma pasta de dentes padronizada foi indicado. Um exame periodontal foi realizado no período inicial e a cada 2 meses usando sondagem do sulco gengival, nível de inserção, recessão, índice de sangramento e presença de biofilme.

Resultado: Diferenças significativas foram observadas na sondagem distal dos dentes ao comparar o período inicial e o grupo de enxaguatório na análise intergrupos, independentemente do lado da boca e do dente avaliado. Ao avaliar o sangramento, o período inicial mostrou 1,8 vezes mais risco de sangramento do que a espuma, 1,9 vezes mais risco do que o controle e 2,4 vezes mais do que o grupo de enxaguatório. Em relação à presença de biofilme, os dados do período inicial mostraram 1,4 vezes mais risco de ter biofilme do que a espuma e 1,9 vezes mais risco do que os grupos de enxaguatório. Em relação ao controle, não houve diferença estatisticamente significativa.

Conclusão: Os pacientes que usaram enxaguatório bucal BlueM tiveram uma menor chance de sangramento e presença de biofilme, assim como melhora da profundidade de sondagem periodontal distal quando comparada ao período inicial.

Palavras-chave

Alinhadores ClearCorrect; saúde periodontal; enxaguatório BlueM; espuma BlueM; tratamento ortodôntico

References

1 Tepedino M, Paoloni V, Cozza P, Chimenti C. Movement of anterior teeth using clear aligners: a three-dimensional, retrospective evaluation. Prog Orthod. 2018 Apr;19(1):9. http://doi.org/10.1186/s40510-018-0207-3. PMid:29607469.

2 White DW, Julien KC, Jacob H, Campbell PM, Buschang PH. Discomfort associated with Invisalign and traditional brackets: a randomized, prospective trial. Angle Orthod. 2017 Nov;87(6):801-8. http://doi.org/10.2319/091416-687.1. PMid:28753032.

3 Levrini L, Mangano A, Margherini S, Tenconi C, Vigetti D, Muollo R, et al. ATP bioluminometers analysis on the surfaces of removable orthodontic aligners after the use of different cleaning methods. Int J Dent. 2016;2016:5926941. http://doi.org/10.1155/2016/5926941. PMid:27242901.

4 Bollen AM, Cunha-Cruz J, Bakko DW, Huang GJ, Hujoel PP. The effects of orthodontic therapy on periodontal health: a systematic review of controlled evidence. J Am Dent Assoc. 2008 Apr;139(4):413-22. http://doi.org/10.14219/jada.archive.2008.0184. PMid:18385025.

5 Cerroni S, Pasquantonio G, Condò R, Cerroni L. Orthodontic fixed appliance and periodontal status: an updated systematic review. Open Dent J. 2018 Sep;12(1):614-22. http://doi.org/10.2174/1745017901814010614. PMid:30369970.

6 Lasserre JF, Brecx M, Toma S. Oral microbes, biofilms and their role in periodontal and peri-implant diseases. Materials. 2018 Sep;11(10):1-17. http://doi.org/10.3390/ma11101802. PMid:30248991.

7 Freitas AO, Marquezan M, Nojima MCG, Alviano DS, Maia LC. The influence of orthodontic fixed appliances on the oral microbiota: a systematic review. Dental Press J Orthod. 2014 Mar-Apr;19(2):46-55. http://doi.org/10.1590/2176-9451.19.2.046-055.oar. PMid:24945514.

8 Karkhanechi M, Chow D, Sipkin J, Sherman D, Boylan RJ, Norman RG, et al. Periodontal status of adult patients treated with fixed buccal appliances and removable aligners over one year of active orthodontic therapy. Angle Orthod. 2013 Jan;83(1):146-51. http://doi.org/10.2319/031212-217.1. PMid:22725616.

9 Shipley TS. Effects of high frequency acceleration device on aligner treatment: a pilot study. Dent J. 2018 Jul;6(3):32. http://doi.org/10.3390/dj6030032. PMid:30002296.

10 Alstad S, Zachrisson BU. Longitudinal study of periodontal condition associated with orthodontic treatment in adolescents. Am J Orthod. 1979 Sep;76(3):277-86. http://doi.org/10.1016/0002-9416(79)90024-1. PMid:290273.

11 Madariaga ACP, Bucci R, Rongo R, Simeon V, D’Antò V, Valletta R. Impact of fixed orthodontic appliance and clear aligners on the periodontal health: a prospective clinical study. Dent J. 2020 Jan;8(1):4. http://doi.org/10.3390/dj8010004. PMid:31906577.

12 Jiang Q, Li J, Mei L, Du J, Levrini L, Abbate GM, et al. Periodontal health during orthodontic treatment with clear aligners and fixed appliances: a meta-analysis. J Am Dent Assoc. 2018 Aug;149(8):712-720.e12. http://doi.org/10.1016/j.adaj.2018.04.010. PMid:29921415.

13 Guo R, Zheng Y, Liu H, Li X, Jia L, Li W. Profiling of subgingival plaque biofilm microbiota in female adult patients with clear aligners: a three-month prospective study. PeerJ. 2018 Jan;6:e4207. http://doi.org/10.7717/peerj.4207. PMid:29312828.

14 Mulla Issa FHK, Mulla Issa ZHK, Rabah AF, Hu L. Periodontal parameters in adult patients with clear aligners orthodontics treatment versus three other types of brackets: a cross-sectional study. J Orthod Sci. 2020 Feb;9(1):4. http://doi.org/10.4103/jos.JOS_54_17. PMid:32166083.

15 Lombardo L, Arreghini A, Maccarrone R, Bianchi A, Scalia S, Siciliani G. Optical properties of orthodontic aligners--spectrophotometry analysis of three types before and after aging. Prog Orthod. 2015;16(1):41. http://doi.org/10.1186/s40510-015-0111-z. PMid:26582007.

16 Axe AS, Varghese R, Bosma M, Kitson N, Bradshaw DJ. Dental health professional recommendation and consumer habits in denture cleansing. J Prosthet Dent. 2016 Feb;115(2):183-8. http://doi.org/10.1016/j.prosdent.2015.08.007. PMid:26547520.

17 Santos VCED, Maquera-Huacho PM, Imbriani MJM, Minhaco VMTR, Spolidorio DMP. Effects of BlueM® against Streptococcus mutans biofilm and its virulence gene expression. Braz Dent J. 2023 Jan-Feb;34(1):19-28. http://doi.org/10.1590/0103-6440202305133. PMid:36888841.

18 Löe H. The Gingival index, the plaque index and the retention index systems. J Periodontol. 1967 Nov-Dec;38(6):610-6. http://doi.org/10.1902/jop.1967.38.6.610. PMid:5237684.

19 Miethke RR, Vogt S. A comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed orthodontic appliances. J Orofac Orthop. 2005 May;66(3):219-29. http://doi.org/10.1007/s00056-005-0436-1. PMid:15959635.

20 Azaripour A, Weusmann J, Mahmoodi B, Peppas D, Gerhold-Ay A, Van Noorden CJ, et al. Braces versus Invisalign®: gingival parameters and patients’ satisfaction during treatment: a cross-sectional study. BMC Oral Health. 2015 Jun;15(1):69. http://doi.org/10.1186/s12903-015-0060-4. PMid:26104387.

21 Levrini L, Mangano A, Montanari P, Margherini S, Caprioglio A, Abbate GM. Periodontal health status in patients treated with the Invisalign(®) system and fixed orthodontic appliances: a 3 months clinical and microbiological evaluation. Eur J Dent. 2015 Jul-Sep;9(3):404-10. http://doi.org/10.4103/1305-7456.163218. PMid:26430371.

22 Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Periodontal health during clear aligners treatment: a systematic review. Eur J Orthod. 2015 Oct;37(5):539-43. http://doi.org/10.1093/ejo/cju083. PMid:25548145.

23 Zhao R, Huang R, Long H, Li Y, Gao M, Lai W. The dynamics of the oral microbiome and oral health among patients receiving clear aligner orthodontic treatment. Oral Dis. 2020 Mar;26(2):473-83. http://doi.org/10.1111/odi.13175. PMid:31418980.

24 Shpack N, Greenstein RB, Gazit D, Sarig R, Vardimon AD. Efficacy of three hygienic protocols in reducing biofilm adherence to removable thermoplastic appliance. Angle Orthod. 2014 Jan;84(1):161-70. http://doi.org/10.2319/012413-75.1. PMid:23786595.

25 Low B, Lee W, Seneviratne CJ, Samaranayake LP, Hägg U. Ultrastructure and morphology of biofilms on thermoplastic orthodontic appliances in ‘fast’ and ‘slow’ plaque formers. Eur J Orthod. 2011 Oct;33(5):577-83. http://doi.org/10.1093/ejo/cjq126. PMid:21187528.

26 Albanna RH, Farawanah HM, Aldrees AM. Microbial evaluation of the effectiveness of different methods for cleansing clear orthodontic retainers: a randomized clinical trial. Angle Orthod. 2017 May;87(3):460-5. http://doi.org/10.2319/072916-585.1. PMid:27845562.

27 Zingler S, Pritsch M, Lux CJ, Kneist S. Association between clinical and salivary microbial parameters during orthodontic treatment with removable appliances with or without use of fluoride mouth rinse. Eur J Paediatr Dent. 2016 Sep;17(3):181-7. PMid:27759405.

28 Qiu J, Hendrixson DR, Baker EN, Murphy TF, St Geme JW 3rd, Plaut AG. Human milk lactoferrin inactivates two putative colonization factors expressed by Haemophilus influenzae. Proc Natl Acad Sci USA. 1998 Oct;95(21):12641-6. http://doi.org/10.1073/pnas.95.21.12641. PMid:9770539.

29 Berlutti F, Pantanella F, Natalizi T, Frioni A, Paesano R, Polimeni A, et al. Antiviral properties of lactoferrin--a natural immunity molecule. Molecules. 2011 Aug;16(8):6992-7018. http://doi.org/10.3390/molecules16086992. PMid:21847071.

30 Wang B, Timilsena YP, Blanch E, Adhikari B. Lactoferrin: structure, function, denaturation and digestion. Crit Rev Food Sci Nutr. 2019;59(4):580-96. http://doi.org/10.1080/10408398.2017.1381583. PMid:28933602.

31 Afennich F, Slot DE, Hossainian N, Van der Weijden GA. The effect of hexetidine mouthwash on the prevention of plaque and gingival inflammation: a systematic review. Int J Dent Hyg. 2011 Aug;9(3):182-90. http://doi.org/10.1111/j.1601-5037.2010.00478.x. PMid:21356020.

32 Cunha EJ, Auersvald CM, Deliberador TM, Gonzaga CC, Esteban Florez FL, Correr GM, et al. Effects of active oxygen toothpaste in supragingival biofilm reduction: a randomized controlled clinical trial. Int J Dent. 2019 Jul;2019:3938214. http://doi.org/10.1155/2019/3938214. PMid:31354823.

33 European Commission Institute for Health and Consumer Protection. Perboric acid, sodium salt. Luxembourg: European Commission; 2007. 36 p.
 

Submitted date:
07/10/2024

Accepted date:
10/08/2024

6751efa5a953955e791012c4 rou Articles
Links & Downloads
1807-2577 (Electronic)
Rev. odontol. UNESP ©2024 All rights reserved.

Rev. odontol. UNESP

Share this page
Page Sections