title: Periodontal health status in patients treated with the Invisalign(®) system and fixed orthodontic appliances: A 3 months clinical and microbiological evaluation.
abstract: OBJECTIVE
  The aim of this prospective study was to compare the periodontal health and the microbiological changes via real-time polymerase chain reaction (PCR) in patients treated with fixed orthodontic appliances and Invisalign(®) system (Align Technology, Santa Clara, California).
  
  
  METHODS
  Seventy-seven patients were enrolled in this study and divided into three groups (Invisalign(®) group, fixed orthodontic appliances group and control group). Plaque index, probing depth, bleeding on probing were assessed. Total biofilm mass and periodontal pathogens were analyzed and detected via real-time PCR. All these data were analyzed at the T0 (beginning of the treatment) T1 (1-month) and T2 (3 months); and statistically compared using the Mann-Whitney test for independent groups.
  
  
  RESULTS
  After 1-month and after 3 months of treatment there was only one sample with periodontopathic anaerobes found in patient treated using fixed orthodontic appliances. The Invisalign(®) group showed better results in terms of periodontal health and total biofilm mass compared to the fixed orthodontic appliance group. A statistical significant difference (P < 0.05) at the T2 in the total biofilm mass was found between the two groups.
  
  
  CONCLUSIONS
  Patients undergoing orthodontic treatment with the Invisalign(®) System show a superior periodontal health in the short-term when compared to patients in treatment with fixed orthodontic appliances. Invisalign(®) should be considered as a first treatment option in patients with risk of developing periodontal disease.
authors.affiliation: Department of Morphological and Surgical Sciences, University of Insubria, Varese, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Levrini
authors.affiliation: Oro Cranio Facial Disease and Medicine Research Centre, University of Insubria, Varese, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mangano
authors.affiliation: Department of Morphological and Surgical Sciences, University of Insubria, Varese, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Montanari
authors.affiliation: Department of Morphological and Surgical Sciences, University of Insubria, Varese, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Margherini
authors.affiliation: Department of Morphological and Surgical Sciences, University of Insubria, Varese, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Caprioglio
authors.affiliation: Department of Morphological and Surgical Sciences, University of Insubria, Varese, Italy.
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Abbate
keywords: Clear aligners; Invisalign; fixed orthodontic treatment; microbiological evaluation; periodontal health