Alineadores vs Brackets Efectos en el Estado Periodontal Durante el Tratamiento
Resumen
El tratamiento ortodóntico, con alineadores o brackets, tiene como objetivo corregir maloclusiones dentales. Sin embargo, afecta de forma significativa la salud periodontal. Este estudio compara los efectos de ambos dispositivos ortodónticos sobre la salud de las encías. Se enfoca en la acumulación de placa dental, los índices de gingivitis, el sangrado al sondear (BOP), las lesiones blancas y la incidencia de periodontitis. Estudios recientes muestran que los pacientes con brackets acumulan más placa. Además, tienen mayor inflamación en las encías y presentan un aumento en los índices de gingivitis y BOP. En cambio, los pacientes con alineadores mostraron mejores resultados en cuanto a salud periodontal. [1] Los pacientes con alineadores experimentaron una menor acumulación de placa, menor inflamación gingival y una menor prevalencia de lesiones blancas y periodontitis. A pesar de la ventaja de los alineadores en términos de higiene oral, los resultados indican que la higiene y el seguimiento adecuado son esenciales para ambos tipos de tratamiento ortodóntico. [2] Se recomienda el uso de cepillos interdentales, enjuagues antimicrobianos y visitas regulares al dentista para los pacientes con brackets, mientras que los pacientes con alineadores deben asegurarse de limpiar adecuadamente tanto sus dientes como los alineadores. Estos hallazgos subrayan la importancia de mantener una higiene rigurosa durante el tratamiento ortodóntico para prevenir complicaciones periodontales. [3]
Descargas
Citas
Sen S, Wani MA, Kour J, Siddiqui S, Chatterjee S, Devi A, et al. Comparative Evaluation of Periodontal Pathogen Load and Health in Patients Treated With Fixed Orthodontic Appliances Versus Clear Aligners: A Prospective Clinical Study. Cureus 2025. https://doi.org/10.7759/cureus.93016.
Dipalma G, Inchingolo AD, Fiore A, Balestriere L, Nardelli P, Casamassima L, et al. The Differential Impact of Clear Aligners and Fixed Orthodontic Appliances on Periodontal Health: A Systematic Review. Children 2025;12. https://doi.org/10.3390/children12020138.
Belanche Monterde A, Flores-Fraile J, Pérez Pevida E, Zubizarreta-Macho Á. Biofilm Composition Changes During Orthodontic Clear Aligners Compared to Multibracket Appliances: A Systematic Review. Microorganisms 2025;13. https://doi.org/10.3390/microorganisms13051039.
Cadenas De Llano-Pérula M, Castro AB, Danneels M, Schelfhout A, Teughels W, Willems G. Risk factors for gingival recessions after orthodontic treatment: a systematic review. Eur J Orthod 2023;45:528–44. https://doi.org/10.1093/ejo/cjad026.
Ristic Vlahovic Svabic M Sasic O Zelic MM, Ristic M, -Ristic AM, Svabic VM. Clinical and microbiological effects of fixed orthodontic appliances on periodontal tissues in adolescents Structured Abstract. 2007. https://doi.org/10.1111/j.1601-6343.2007.00396.x.
Di Spirito F, D’Ambrosio F, Cannatà D, D’Antò V, Giordano F, Martina S. Impact of Clear Aligners versus Fixed Appliances on Periodontal Status of Patients Undergoing Orthodontic Treatment: A Systematic Review of Systematic Reviews. Healthcare (Switzerland) 2023;11. https://doi.org/10.3390/healthcare11091340.
Miethke RR, Brauner K. Vergleich der Parodontalbefunde zwischen Invisalign®-Patienten und Patienten mit festsitzenden Lingualapparaturen. Journal of Orofacial Orthopedics 2007;68:223–31. https://doi.org/10.1007/s00056-007-0655-8.
Alasiri MM, Almalki A, Alotaibi S, Alshehri A, Alkhuraiji AA, Thomas JT. Association between Gingival Phenotype and Periodontal Disease Severity—A Comparative Longitudinal Study among Patients Undergoing Fixed Orthodontic Therapy and Invisalign Treatment. Healthcare (Switzerland) 2024;12. https://doi.org/10.3390/healthcare12060656.
Bucur SM, Bud E, Decusară M, Olteanu CD. Retrospective Study on Orthodontic Gingival Recession Correction Using Clear Aligners. Medicina (Lithuania) 2024;60. https://doi.org/10.3390/medicina60122024.
Bagalkot KB, Saha P, Chikhalia DK, Kumar A, Aulakh S, Purkayastha A, et al. Clear Aligners or Traditional Braces? An Effective Plan in the Ortho-Perio Treatment of Gingival Recessions. J Pharm Bioallied Sci 2025;17:S3189–91. https://doi.org/10.4103/jpbs.jpbs_1277_25.
Cenzato N, Occhipinti C, D’amici E, Savadori P, Baldini B, Maspero C. Microbiological Analysis of Plaque and Its Composition in Three Patient Groups under Different Orthodontic Treatments. Dent J (Basel) 2024;12. https://doi.org/10.3390/dj12060168.
Kredig C, Peuckert E, Schmidtmann I, Drechsler T, Erbe C. Oral health in adolescents: periodontal inflammatory biomarkers during orthodontic clear aligner therapy. Clin Oral Investig 2025;29. https://doi.org/10.1007/s00784-025-06212-9.
Kozak U, Lasota A, Chałas R. Changes in distribution of dental biofilm after insertion of fixed orthodontic appliances. J Clin Med 2021;10. https://doi.org/10.3390/jcm10235638.
Marincak Vrankova Z, Rousi M, Cvanova M, Gachova D, Ruzicka F, Hola V, et al. Effect of fixed orthodontic appliances on gingival status and oral microbiota: a pilot study. BMC Oral Health 2022;22. https://doi.org/10.1186/s12903-022-02511-9.
Partouche AJD, Castro F, Baptista AS, Costa LG, Fernandes JCH, Fernandes GV de O. Effects of Multibracket Orthodontic Treatment versus Clear Aligners on Periodontal Health: An Integrative Review. Dent J (Basel) 2022;10:177. https://doi.org/10.3390/dj10100177.
Shokeen B, Viloria E, Duong E, Rizvi M, Murillo G, Mullen J, et al. The impact of fixed orthodontic appliances and clear aligners on the oral microbiome and the association with clinical parameters: A longitudinal comparative study. American Journal of Orthodontics and Dentofacial Orthopedics 2022;161:e475–85. https://doi.org/10.1016/j.ajodo.2021.10.015.
Zhao R, Huang R, Long H, Li Y, Gao M, Lai W. The dynamics of the oral microbiome and oral health among patients receiving clear aligner orthodontic treatment. Oral Dis 2020;26:473–83. https://doi.org/10.1111/odi.13175.
Crego-Ruiz M, Jorba-García A. Assessment of the periodontal health status and gingival recession during orthodontic treatment with clear aligners and fixed appliances: A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2023;28:e330–40. https://doi.org/10.4317/medoral.25760.
Oikonomou E, Foros P, Tagkli A, Rahiotis C, Eliades T, Koletsi D. Impact of Aligners and Fixed Appliances on Oral Health during Orthodontic Treatment: A Systematic Review and Meta-Analysis. Oral Health Prev Dent 2021;19:659–72. https://doi.org/10.3290/j.ohpd.b2403661.
Joss-Vassalli I, Grebenstein C, Topouzelis N, Sculean A, Katsaros C, Joss-Vassalli I. Orthodontic therapy and gingival recession: a systematic review. 2010.
Lemos M, Cattaneo P, Melsen B, Faveri M. JIAP October 2020 - Impact of Treatment with Full-fixed Orthodontic Appliances on the Periodontium and the Composition of the Subgingival Microbiota. J Int Acad Periodontol 2020;22:174–81.
Karkhanechi M, Chow D, Sipkin J, Sherman D, Boylan RJ, Norman RG, et al. Periodontal status of adult patients treated with fixed buccal appliances and removable aligners over one year of active orthodontic therapy. Angle Orthodontist 2013;83:146–51. https://doi.org/10.2319/031212-217.1.
Mulla Issa F, Mulla Issa Z, Rabah A, Hu L. Periodontal parameters in adult patients with clear aligners orthodontics treatment versus three other types of brackets: A cross-sectional study. J Orthod Sci 2020;9. https://doi.org/10.4103/jos.JOS_54_17.
Pango Madariaga AC, Bucci R, Rongo R, Simeon V, D’Antò V, Valletta R. Impact of fixed orthodontic appliance and clear aligners on the periodontal health: A prospective clinical study. Dent J (Basel) 2020;8. https://doi.org/10.3390/dj8010004.
Yáñez-Vico RM, Iglesias-Linares A, Ballesta-Mudarra S, Ortiz-Ariza E, Solano-Reina E, Perea EJ. Short-term effect of removal of fixed orthodontic appliances on gingival health and subgingival microbiota: A prospective cohort study. Acta Odontol Scand 2015;73:496–502. https://doi.org/10.3109/00016357.2014.993701.
Levrini L, Mangano A, Montanari P, Margherini S, Caprioglio A, Abbate GM. Periodontal health status in patients treated with the Invisalign® system and fixed orthodontic appliances: A 3 months clinical and microbiological evaluation. Eur J Dent 2015;9:404–10. https://doi.org/10.4103/1305-7456.163218.
Barreda GJ. Expansion treatment using Invisalign®: Periodontal health status and maxillary buccal bone changes. A clinical and tomographic evaluation. vol. 33. 2020.
Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Periodontal health during clear aligners treatment: A systematic review. Eur J Orthod 2015;37:539–43. https://doi.org/10.1093/ejo/cju083.
Han JY. A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis. J Periodontal Implant Sci 2015;45:193–204. https://doi.org/10.5051/jpis.2015.45.6.193.
Bin Bahar BSK, Alkhalidy SR, Kaklamanos EG, Athanasiou AE. Do orthodontic patients develop more gingival recession in anterior teeth compared to untreated individuals? A systematic review of controlled studies 2019. https://doi.org/10.1016/j.
Lu H, Tang H, Zhou T, Kang N. Assessment of the periodontal health status in patients undergoing orthodontic treatment with fixed appliances and Invisalign system. Medicine (United States) 2018;97. https://doi.org/10.1097/MD.0000000000010248.
Jiang Q, Li J, Mei L, Du J, Levrini L, Abbate GM, et al. Periodontal health during orthodontic treatment with clear aligners and fixed appliances: A meta-analysis. Journal of the American Dental Association 2018;149:712-720.e12. https://doi.org/10.1016/j.adaj.2018.04.010.
NAGANI NI, AHMED I. Comparison of multistranded wire and fiber-reinforced composite retainers effects on periodontium: A randomized clinical trial. Dental Press J Orthod 2023;28. https://doi.org/10.1590/2177-6709.28.1.e2319380.oar.
Partouche AJD, Castro F, Baptista AS, Costa LG, Fernandes JCH, Fernandes GV de O. Effects of Multibracket Orthodontic Treatment versus Clear Aligners on Periodontal Health: An Integrative Review. Dent J (Basel) 2022;10:177. https://doi.org/10.3390/dj10100177.
Partouche AJD, Castro F, Baptista AS, Costa LG, Fernandes JCH, Fernandes GV de O. Effects of Multibracket Orthodontic Treatment versus Clear Aligners on Periodontal Health: An Integrative Review. Dent J (Basel) 2022;10. https://doi.org/10.3390/dj10100177.
Inchingolo F, Inchingolo AM, Ceci S, Carpentiere V, Garibaldi M, Riccaldo L, et al. Orthodontic Relapse after Fixed or Removable Retention Devices: A Systematic Review. Applied Sciences 2023;13:11442. https://doi.org/10.3390/app132011442.
Derechos de autor 2026 Miller Israel Molina Montesdeoca , Dayana Carolina Guamán Lozada, Mayra Alejandra Jácome Torres
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
.png)
.png)
1.png)
