Stomatológ 2025, 35(1):35-42

Level of oral hygiene in treatment with fixed appliances and clear aligners

MDDr. Natália Gerdová1,2, MDDr. Eleonóra Ivančová, PhD.1,2, MUDr. Vladimíra Schwartzová, PhD., MPH, MHA1
1 Klinika Stomatológie a maxilofaciálnej chirurgie UPJŠ Lekárska fakulta a UNLP Košice
2 DDDental s. r. o., neštátna stomatologická ambulancia Košice

ABSTRACT The authors of the study examine the impact of fixed appliances and clear aligners on oral hygiene levels, investigating how these devices affect biofilm formation, as well as the development of supragingival and subgingival plaque, including its microbiological composition. They assess the level of oral hygiene of patients using plaque detection methods and the application of the quantitative QHI index. The cohort of patients is analyzed and categorized based on research group, gender, and age. The aim of the study was to gain insights into the impact of fixed appliances and clear aligners on oral hygiene levels and provide useful information for practical application. The authors found that the QHI index values were lower in patients with clear aligners, as these devices provide more favorable conditions for performing oral hygiene procedures. They conclude that the key factors are patient cooperation, practical instructions, and motivation from the orthodontist in collaboration with the dental hygienist. The conclusion follows that the type of orthodontic appliance ultimately does not determine the level of oral hygiene.

Keywords: fixed appliance, foil appliance, plaque, QHI index, oral hygiene

Published: July 1, 2025  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Gerdová N, Ivančová E, P, Schwartzová V, MHA. Level of oral hygiene in treatment with fixed appliances and clear aligners. Stomatológ. 2025;35(1):35-42.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. ALBHAISI, Z., AL-KHATEEB, S. N., ABU ALHAIJA, E. S. (2020). Enamel demineralization during clear aligner orthodontic treatment compared with fixed appliance therapy, evaluated with quantitative light-induced fluorescence: A randomized clinical trial. American Journal of Orthodontics and Dentofacial Orthopedics, Vol 157(5), p. 594-601. Dostupné na: https://doi.org/10.1016/j.ajodo.2020.01.004ANDRUCIOLI, M. C. D., NELSON-FILHO, P., MATSUMOTO, M. A. N., SARAIVA, M. C. P., FERES, M., DE FIGUEIREDO, L. C., MARTINS, L. P. (2012). Molecular detection of in-vivo microbial contamination of metallic orthodontic brackets by checkerboard DNA-DNA hybridization. American Journal of Orthodontics and Dentofacial Orthopedics, Vol. 141, Issue 1, p. 24-29. ISSN 0889-5406. Dostupné na: https://doi.org/10.1016/j.ajodo.2011.06.036 Go to original source...
    2. AZEEM, M., HAMID, W. U. (2017). Incidence of white spot lesions during orthodontic clear aligner therapy. Journal of the World Federation of Orthodontists, Vol. 6, Issue 3, p. 127-130. ISSN 2212- 4438. Dostupné na: https://doi.org/10.1016/j.ejwf.2017.07.001 Go to original source...
    3. BAKA, Z. M., BASCIFTCI, F. A., ARSLAN, U. (2013). Effects of 2 bracket and ligation types on plaque retention: A quantitative microbiologic analysis with real-time polymerase chain reaction. American Journal of Orthodontics and Dentofacial Orthopedics, Vol. 144, Issue 2, p. 260-267. ISSN 0889-5406. Dostupné na: https://doi.org/10.1016/j.ajodo.2013.03.022 Go to original source... Go to PubMed...
    4. BUSCHANG, P. H., CHASTAIN, D., KEYLOR, C. L., CROSBY, D., JULIEN, K. C. (2019). Incidence of white spot lesions among patients treated with clear aligners and traditional braces. Angle Orthodontist, Vol. 89, Issue 3, p. 359-364, Dostupné na: https://doi.org/10.2319/073118-553.1 Go to original source... Go to PubMed...
    5. ELIADES, T., KATSAROS, CH. (2019). The Ortho-Perio Patient, Quintessence Pub Co., ISBN 978-0-86715-679-9, 224 p.
    6. GUJAR, A. N., AL-HAZMI, A., RAJ, A. T., PATIL, S. (2020). Microbial profile in different orthodontic appliances by checkerboard DNA-DNA hybridization: An in-vivo study. American Journal of Orthodontics and Dentofacial Orthopedics, 157(1), p. 49-58. Dostupné na: https://doi.org/10.1016/j.ajodo.2019.01.026 Go to original source... Go to PubMed...
    7. GUO, R., ZHENG, Y., LIU, H., LI, X., JIA, L., LI, W. (2018). Profiling of subgingival plaque biofilm microbiota in female adult patients with clear aligners: a three-month prospective study. PeerJ, 6, e4207. Dostupné na: https://doi.org/10.7717/peerj.4207 Go to original source... Go to PubMed...
    8. GUO, R., LIN, Y., ZHENG, Y., et al. (2017). The microbial changes in subgingival plaques of orthodontic patients: a systematic review and meta-analysis of clinical trials. BMC Oral Health, 17, 90. Dostupné na: https://doi.org/10.1186/s12903-017-0378-1 Go to original source... Go to PubMed...
    9. VAN GASTEL, J., QUIRYNEN, M., TEUGHELS, W., COUCKE, W., CARELS, C. (2008). Longitudinal Changes in Microbiology and Clinical Periodontal Variables After Placement of Fixed Orthodontic Appliances. Journal of Periodontology, 79(11), p. 2078-2086. Dostupné na: https://doi.org/10.1902/jop.2008.080153 KHAN, R., ANTONY, V. (2013). Investigation of the Periodontal and Microbiological Status of Patients Undergoing Fixed Orthodontic Therapy. IOSR Journal of Dental and Medical Sciences, vol. 7. Dostupné na: https://doi.org/10.9790/0853-0748085 Go to original source... Go to PubMed...
    10. KOVAĽOVÁ, E. a kol. (2010). Orálna Hygiena II., III. Prešov: KK dent s.r.o., ISBN: 9788089295241, 680 p.
    11. KOVAĽOVÁ, E., KONEČNÝ, M., ŠESTÁKOVÁ, M. (2023). Parodontológia 5. Michal Vaško vydavateľstvo. ISBN: 978-80-8198- 054-1
    12. LOMBARDO, L., PALONE, M., SCAPOLI, L., SICILIANI, G., CARINCI, F. (2021). Short-term variation in the subgingival microbiota in two groups of patients treated with clear aligners and vestibular fixed appliances: A longitudinal study. Orthod Craniofac Res. 2021;24:251- 260. Dostupné na: https://doi.org/10.1111/ocr.12427 Go to original source... Go to PubMed...
    13. LU, H., TANG, H., ZHOU, T., KANG, N. (2018). Assessment of the periodontal health status in patients undergoing orthodontic treatment with fixed appliances and Invisalign system: A metaanalysis. Medicine.; 97(13):e0248. Dostupné na: https://doi.org/10.1097/MD.0000000000010248 Go to original source... Go to PubMed...
    14. MADARIAGA, A. C., BUCCI, R., RONGO, R., SIMEON, V., D'ANTÒ, V.,VALLETTA, R. (2020). Impact of Fixed Orthodontic Appliance and Clear Aligners on the Periodontal Health: A Prospective Clinical Study. Dentistry Journal, 8(1), 4. Dostupné na: https://doi.org/10.3390/dj8010004 Go to original source... Go to PubMed...
    15. Mahmoud GA, Gordon PH, Pretty IA, McCabe JF, Hajeer MY. (2023) Effect of Fluoride Release on Enamel Demineralization Adjacent to Orthodontic Brackets. Cureus. Sep 28;15(9):e46132. Dostupné na: doi: 10.7759/cureus.46132. PMID: 37779682; PMCID: PMC10538356. Go to original source... Go to PubMed...
    16. Marincak Vrankova, Z., Rousi, M., Cvanova, M. et al. (2022). Effect of fixed orthodontic appliances on gingival status and oral microbiota: a pilot study. BMC Oral Health 22, 455. Dostupné na: HYPERLINK "https://doi.org/10.1186/s12903-022-02511-9" \t "https://euc-word-edit.officeapps.live.com/we/_blank" https://doi.org/10.1186/s12903-022-02511-9 Go to original source... Go to PubMed...
    17. MEI, L., CHIENG, J., WONG, C., et al. (2017). Factors affecting dental biofilm in patients wearing fixed orthodontic appliances. Progress in Orthodontics, 18(1), 4. Dostupné na: https://doi.org/10.1186/s40510-016-0158-5 Go to original source... Go to PubMed...
    18. MULLA, I. FHK, MULLA, I. ZHK, RABAH, A. F., HU, L. (2020). Periodontal parameters in adult patients with clear aligners orthodontics treatment versus three other types of brackets: A crosssectional study. Journal of Orthodontic Science, 9, 4. Dostupné na: https://doi.org/10.4103/jos.JOS_54_17 Polke P, Jain U, Marothiya S, Agrawal P, Dixit S, Dubey C. (2020). Comparative Evaluation of Biofilm Adhesion to Different Types of Archwire and Microbiological Colonization During Orthodontic Treatment. Journal of Indian Orthodontic Society.; 55(2):150-157. Dostupné na: doi: HYPERLINK "https://doi. org/10.1177/0301574220957794" \t "https://euc-word-edit.officeapps. live.com/we/_blank" 10.1177/0301574220957794 Go to original source... Go to PubMed...
    19. ROUZI, M., ZHANG, X., JIANG, Q., LONG, H., LAI, W., LI, X. (2023). Impact of Clear Aligners on Oral Health and Oral Microbiome During Orthodontic Treatment. Int Dent J. Dostupné na: https://doi.org/10.1016/j.identj.2023.03.012 Go to original source... Go to PubMed...
    20. SHOKEEN, B., VILORIA, E., DUONG, E., RIZVI, M., et al. (2022). The impact of fixed orthodontic appliances and clear aligners on the oral microbiome and the association with clinical parameters: A longitudinal comparative study. Am J Orthod Dentofacial Orthop, 161(5), e475-e485. Dostupné na: https://doi.org/10.1016/j.ajodo.2021.10.015 Go to original source... Go to PubMed...
    21. SREENIVASAN, P. K., PRASAD, K. V. V., JAVALI, S. B. (2016). Oral health practices and prevalence of dental plaque and gingivitis among Indian adults. Clin Exp Dent Res. Jan;2(1):6-17. Dostupné na: https://doi.org/10.1002/cre2.15 Go to original source... Go to PubMed...
    22. TAYANIN, G., MOSLEHZADEH, K. (2010). Quigley Hein Index. Dostupné na: http://www.whocollab.od.mah.se/expl/ohituresky70.html
    23. TEZAL, M., SCANNAPIECO, F. A., WACTAWSKI-WENDE, J., GROSSI, S. G., GENCO, R. J. (2006). Supragingival plaque may modify the effects of subgingival bacteria on attachment loss. J Periodontol, 77(5), p. 808-813. Dostupné na: https://doi.org/10.1902/jop.2006.050332 Go to original source... Go to PubMed...
    24. TURESKY, S., GILMORE, N. D., GLICKMAN, I. (1970). Reduced plaque formation by the chloromethyl analogue of vitamin C. J Periodontol. 1;41(1):41-3. Dostupné na: https://doi.org/ 10.1902/jop.1970.41.41.41 Go to original source... Go to PubMed...
    25. WU, Y., CAO, L., CONG, J. (2020). The periodontal status of removable appliances vs fixed appliances: A comparative metaanalysis. Medicine (Baltimore). 99(50): e23165. Dostupné na: https://doi.org/10.1097/MD.0000000000023165 Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content