P-56240663-116 - Surgery first and Invisalign: A comparative assessment of periodontal health in postsurgical orthodontic treatment with Invisalign or traditional fixed appliances

Abstract

<h3>Introduction</h3> Removable clear aligners have become very popular in the last few decades, but they are still little used in the field of orthognathic surgery. The objective of this 2-arm parallel trial was to compare periodontal health associated to postsurgical orthodontic treatment with either fixed orthodontic appliances or clear aligners. <h3>Methods</h3> Patients with dentofacial deformities undergoing orthognathic surgery (OS) at our institution were randomly allocated to receive postsurgical orthodontic treatment with either Invisalign or fixed orthodontic appliances. Eligibility criteria included: 1) skeletal malocclusion requiring combined surgical and orthodontic treatment without extractions; and 2) informed consent for this novel protocol. The main outcome was plaque index (PI). The secondary outcomes were probing depth (PD) and bleeding on probing (BP). The data were analyzed at T1 (immediately before surgery) and T2 (end of orthodontic treatment). The total duration of treatment was also recorded. <h3>Results</h3> Twenty-eight patients (mean age at the time of surgery, 30.75 years, range 18-52 years) were randomized in a 1:1 ratio to either fixed orthodontic appliances or Invisalign. Sixteen patients were women and 12 were men. Baseline characteristics were similar between groups. The means and standard deviations of PI at T1 (Invisalign, 0.86±0.77; brackets, 1.57±0.94) were similar (p=0.05). However, they were statistically significant (p=0.001) at T2 (Invisalign, 0.64±0.75; brackets, 1.79±0.58). No adverse events occurred during the study. <h3>Conclusion</h3> Within the limits of this study, it can be concluded that compared to traditional orthodontics with fixed appliances, patients managed with clear aligners after orthognathic surgery (surgery-first approach) had better periodontal outcomes.