Biofilm Composition Changes During Orthodontic Clear Aligners Compared to Multibracket Appliances: A Systematic Review

doi:10.3390/microorganisms13051039

★ Alto impactoQ1 · Biochemistry, Genetics and Molecular BiologyImpact Factor · 4.729

AutoresAlba Belanche Monterde, Javier Flores‐Fraile, Esteban Pérez-Pevida, Álvaro Zubizarreta‐Macho

Por qué importa

Una revisión sistemática comparó la composición del biofilm oral en pacientes tratados con alineadores transparentes frente a ortodoncia con brackets multilinguales. El estudio analizó 20 artículos seleccionados de bases de datos electrónicas, evaluando tanto el análisis cuantitativo como cualitativo de la diversidad microbiana. Los hallazgos sugieren que el tratamiento con alineadores transparentes genera menos disbiosis bacteriana en comparación con los aparatos fijos, lo cual es relevante dado que la disbiosis oral se relaciona con condiciones sistémicas inflamatorias e incluso con el desarrollo de ciertos cánceres. Si bien se observaron alteraciones microbiológicas durante el uso de alineadores, su menor impacto en el biofilm supra y subgingival los posiciona como una opción potencialmente favorable para pacientes con riesgo periodontal. La relación Firmicutes/Bacteroidetes se destaca por su papel en este proceso.

Abstract original

Clear aligner treatment seems to be a good option for the periodontal patient by the reason of being removable. Multibracket appliances are more difficult to mantain clean and some bacteria might prefer to adhere on the archwire. A systematic review was carried out using 4 electronic databases (Pubmed-Medline, Scopus, Cochrane and Web of Science). The selected trials included quantitative (Shannon index, Simpson index, relative abundances) and/or qualitative (alpha and beta diversity) analysis in patients using clear aligners and multibracket appliances. Initially, a total of 123 articles were found after selecting clinical trials. The inclusion and exclusion criteria were applied by two authors. Finally, 20 articles were selected for the systematic review. The results showed that clear aligner treatment produced less dysbiosis in the selected bacteria compared to multibracket appliances. However, some microbiological changes were observed in some articles during clear aligner use. Oral dysibiosis was related with intestinal dysbiosis, inflammatory response and even cancer. The Firmicutes/Bacteroidetes ratio showed to have a very important role in this development. Periodontitis is also a bacterial disease and clear aligners were recommended to periodontal risk patients. Clear aligner treatment obtained less supra and subgingival biofilm changes compared with multibracket appliances but some bacteria were altered during treatment.

Leer texto completo ↗DOI · 10.3390/microorganisms13051039

Autor Doctor&Cols

Esteban Pérez Pevida
Cirugía Oral e Implantología

Cómo citar

Monterde AB, 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. doi:10.3390/microorganisms13051039