The Impact of Orthodontic Treatment on Periodontal Health and Quality of Life in Athletes: Clear Aligners vs Fixed Appliances - Narrative Review

Abstract

Background:

Orthodontic treatment, although necessary for improving aesthetics and function, poses challenges to periodontal health. Appliance components, such as brackets and wires, impair mechanical plaque control, which may contribute to inflammation, enamel demineralization, and alterations in the oral microbiome.

Aim: 

The aim of this narrative review is to compare the impact of fixed appliances and clear aligners on periodontal parameters, microbiological and structural changes, and quality of life, with emphasis on athletes.

Material and methods:

This paper searched the literature in electronic databases, including PubMed, using keywords: “Fixed Appliances vs Clear Aligners”, “White Spot Lesions”, “Periodontal Health”, “Athletes”, “Quality of Life”. Articles included randomized controlled trials, meta-analyses, and systematic reviews since 2015.

Results: 

Studies indicate that patients treated with aligners maintain better oral hygiene, as reflected by lower plaque and gingival indices, especially in the early treatment stages. Fixed appliances are associated with greater microbiome dysbiosis, promoting the growth of Gram-negative and anaerobic bacteria. Regarding structural complications, fixed appliances are linked to significantly greater external apical root resorption. For athletes, the reduced pain intensity, decreased risk of mucosal injuries, and no impact of aligners on nutrition compared with braces are particularly relevant.

Conclusions: 

Clear aligners provide significant benefits over fixed appliances regarding maintaining periodontal health and improving quality of life. Due to their protective splint-like effect, lower pain intensity, and no impact on chewing comfort, clear aligners may be preferred over fixed appliances in athletes.