," /> ,"/> Clinical efficacy of clear aligner treatment for pathologically migrated teeth in the anterior region of patients with severe periodontitis
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Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (1): 51-56. doi: 10.19723/j.issn.1671-167X.2025.01.008

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Clinical efficacy of clear aligner treatment for pathologically migrated teeth in the anterior region of patients with severe periodontitis

Jingqian LI1, Zilu ZHU1, Jian JIAO2, Jie SHI1,*()   

  1. 1. Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
    2. First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
  • Received:2024-10-09 Online:2025-02-18 Published:2025-01-25
  • Contact: Jie SHI E-mail:sjlily@yeah.net
  • Supported by:
    the Beijing Natural Science Foundation-Combined Fund of Haidian Original Innovation Fund(L232107)

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Abstract:

Objective: To evaluate the clinical efficacy of clear aligner therapy in patients with severe periodontitis accompanied by pathological tooth displacement in the anterior region. Methods: This retrospective study analyzed patients diagnosed with severe periodontitis and pathological displacement in the anterior region, who visited both the Periodontics and Orthodontics Departments at Peking University School and Hospital of Stomatology between 2019 and 2022. A total of 26 eligible cases were included in this study. All the patients underwent regular periodontal maintenance throughout the treatment process, and clear aligners were used for orthodontic treatment. Intraoral scans were analyzed by dedicated software to measure and compare occlusal distribution and proximal contact scores before and after orthodontic treatment. Periodontal clinical indicators were assessed at three key time points: before periodontal treatment (T0), before orthodontic treatment (T1), and after orthodontic treatment (T2). All the cases were treated with clear aligner. Results: A total of 217 pathologically displaced anterior teeth from 26 patients were analyzed. Among these, 105 teeth exhibited periodontal pockets [probing depth (PD) ≥5 mm] before periodontal treatment. After clear aligner therapy, the occlusal score improved significantly from 10.35±8.61 to 23.62±9.73 (P < 0.001), and the proximal contact score increased from 13.62±4.73 to 31.62±10.37 (P < 0.001). The median PD decreased significantly from 3.33 mm [interquartile range (IQR)=0.92] at T0 to 2.50 mm (IQR=0.67, P < 0.001) at T1 and remained stable at 2.50 mm (IQR=0.50) after treatment (T2). A significant reduction in PD was observed between T0 and T2 (P < 0.001), but no significant difference was found between T1 and T2 (P=0.948). Conclusion: Clear aligner therapy demonstrates favorable clinical efficacy in patients with severe periodontitis and pathological anterior tooth displacement. It effectively improves occlusal distribution and proximal contact while maintaining periodontal health in these patients. However, further large-scale prospective controlled studies are needed to verify its long-term clinical outcomes.

Key words: Orthodontic treatment, Periodontitis, Removable orthodontic appliances, Dental occlusion

CLC Number: 

  • R783.5

Figure 1

Accumulated points rules for occlusal force distribution score A, when the occlusal distribution color is only blue, points will be halved; B, compact occlusion area located on the middle gingiva of two teeth (arrow)."

Figure 2

Changes in the distribution of maxillary and mandibular occlusal force of patients before and after orthodontic treatment A, distribution of maxillary occlusal force before invisible orthodontics; B, distribution of mandibular occlusal force before invisible orthodontics; C, distribution of maxillary occlusal force after invisible orthodontics; D, distribution of mandibular occlusal force after invisible orthodontics."

Figure 3

Changes in mean occlusal force distribution score (A) and proximal contact score (B) of patients before (T1) and after orthodontic treatment (T2) (mean±standard deviation, paired t test) * * * P < 0.001."

Figure 4

Changes in the ratio of mean PD (A), maximum PD (B) and maximum BI (C) of the affected teeth before periodontal treatment (T0), before (T1) and after orthodontic treatment (T2) (Friedman test and Dunn multiple comparison test) * * P < 0.01; * * * P < 0.001. PD, probing depth; BI, bleeding index; Max, maximum; ns, no significance."

Figure 5

Ratio changes of mean PD (A), maximum PD (B) and maximum BI (C) of the affected teeth before (T1) and after orthodontic treatment (T2) in teeth with PD ≥5 mm before periodontal treatment (T0) (Friedman test and Dunn multiple comparison test) * * * P < 0.001. PD, probing depth; BI, bleeding index; Max, maximum; ns, no significance."

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