Oral health in adolescents : periodontal inflammatory biomarkers during orthodontic clear aligner therapy

Abstract

Objectives This prospective study aimed to evaluate periodontal inflammation in adolescents undergoing orthodontic treatment with clear aligners (Invisalign® Teen, Align Technology, San Jose, CA, USA). Key objectives included assessing the presence of 11 periodontitis-associated marker bacteria, active matrix metalloproteinase-8 concentrations in sulcular fluid, and the influence of IL-1 polymorphism genotypes on periodontal health. Materials and methods Fifty adolescent patients (13.3 ± 1.8 years) with mixed and permanent dentition participated. Gingival crevicular fluid samples were analyzed at multiple time points: before, during, and one year after aligner treatment. Periodontal health was assessed using the Gingivitis Index and the Modified Quigley-Hein Index. Genotypic analysis of IL-1 polymorphism was also performed. Statistical analyses included mixed linear models and generalized linear models to explore correlations. Results All combinations of IL-1 polymorphism genotypes were found in the sample. No significant increase in periodontal inflammation or aMMP-8 concentrations was observed over the treatment period. Marker bacteria from the red and orange-associated complexes remained at low levels, while significant changes occurred in the orange and green complexes, particularly Capnocytophaga spp. (p = 0.0042) and Fusobacterium spp. (p = 0.0365). GI correlated significantly with aMMP-8 levels (p = 0.0017), but no genotype effect on GI was observed. MQH showed associations with pathogens from the orange and green complexes, including Capnocytophaga spp. and Fusobacterium spp. Conclusions Clear aligner treatment in adolescents, including those with an unfavorable genotype, does not increase periodontal inflammation when accompanied by good oral hygiene. Clinical relevance Regular periodontal monitoring and hygiene reinforcement is important during orthodontic treatment, especially in adolescent patients.