Comparative Periodontal Health in Patients Undergoing Orthodontic Treatment with Clear Aligners Versus Fixed Appliances: A Questionnaire-Based Study

Abstract

Background: Orthodontic appliances influence plaque accumulation and periodontal health. Fixed orthodontic appliances often hinder effective oral hygiene, whereas clear aligners are removable and may facilitate better plaque control.
Aim: To compare periodontal health outcomes in patients undergoing orthodontic treatment with fixed appliances and clear aligners.
Materials and Methods: A cross‑sectional questionnaire‑based study (16 questions) was conducted over 6–9 months among 364 orthodontic patients. Participants were categorized into two groups: fixed appliance therapy (n=227) and clear aligner therapy (n=137). Parameters assessed included gingival bleeding, gingival swelling, halitosis, gingival recession, oral hygiene compliance, and patient‑perceived gum health outcomes. Data were analyzed using descriptive statistics and Chi‑square test using SPSS version 25.0. A p‑value <0.05 was considered statistically significant.
Results: Among the participants, 227 (62.4%) were treated with fixed appliances and 137 (37.6%) with clear aligners. Patients treated with fixed appliances reported significantly higher gingival bleeding, swelling, halitosis, and gingival recession. Oral hygiene compliance and perceived improvement in gum health were higher among aligner patients.
Conclusion: Clear aligner therapy demonstrated comparatively better periodontal health outcomes than fixed orthodontic appliances, possibly due to improved accessibility for oral hygiene maintenance.
Keywords: Clear aligners, Fixed orthodontic appliances, Periodontal health, Orthodontic treatment, Oral hygiene