Abstract
Background/objective: In orthodontic therapy, the periodontal ligament plays a critical role in the bone remodeling process by stimulating osteoblasts in tension zones and promoting bone resorption through osteoclasts in compression zones in response to mechanical stress. These processes are regulated by key cytokines, such as RANKL and IL-1, which are influenced by factors such as patient age and force application. This work evaluates the effectiveness of clear aligners versus traditional braces on periodontal health in patients with periodontitis, following PRISMA guidelines and utilizing specific inclusion and exclusion criteria. Methods: A systematic review of 1664 records was conducted, leading to the inclusion of eight studies that focus on the impact of orthodontic treatments on periodontal health. The review identifies various biases present in the literature. Results: The findings reveal that clear aligners, in contrast to fixed appliances, improve oral hygiene and reduce inflammation, leading to better periodontal outcomes. Fixed appliances, on the other hand, may exacerbate plaque accumulation and inflammation, which can worsen periodontal health. Conclusions: Clear aligners offer advantages over fixed appliances in terms of enhancing periodontal health, improving patient compliance, and providing long-term benefits, particularly in patients with severe periodontitis. The effectiveness of clear aligners is linked to better management of periodontal complications and overall oral hygiene. Treatment decisions should be based on patient-specific criteria to optimize outcomes.