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Alterações periodontais induzidas pelos alinhadores dentários em comparação com aparelhos multibrackets
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Advisor(s)
Abstract(s)
Durante o tratamento ortodôntico, os dentes são submetidos a forças biomecânicas que desencadeiam respostas biológicas no periodonto. Existe, portanto, uma forte interrelação entre ortodontia e periodontologia, sendo essencial avaliar o estado periodontal antes e durante o tratamento ortodôntico para garantir o seu sucesso.
Este trabalho tem como objetivo comparar os efeitos periodontais provocados por aparelhos fixos multibrackets e por alinhadores dentários, considerando as diferenças
biomecânicas entre ambos os sistemas. Pretende-se verificar se existem diferenças nos parâmetros clínicos periodontais entre os aparelhos, nomeadamente nos índices
periodontais e na ocorrência de disbiose microbiana. Além disso, pretende-se avaliar se um dos dispositivos permite uma melhor preservação da saúde periodontal, com especial atenção para os pacientes com risco aumentado de doença periodontal.
Metodologia: Realizou-se uma revisão com base em artigos científicos publicados entre 2004 e 2024, recorrendo às bases de dados PubMed, Google Scholar, SciELO,
ScienceDirect, B-on e Scopus, assim como o acervo bibliográfico da biblioteca da Egas Moniz School of Health & Science. Serão considerados apenas estudos realizados na
espécie Humana, publicados em português, francês ou inglês.
Conclusões: Os alinhadores tendem a estar associados a melhores índices gengivais e menor acúmulo de placa, principalmente devido à sua removibilidade. No entanto, os
dados disponíveis apresentam limitações metodológicas e resultados contraditórios. A eficácia da higiene oral parece ser mais determinante para a saúde periodontal do que o tipo de aparelho. As diferenças de força ortodôntica (contínua vs. intermitente) não demonstram impacto clínico relevante a longo prazo. Assim, não é possível afirmar com
certeza a superioridade de um sistema sobre o outro.
Objectives: During orthodontic treatment, teeth are subjected to biomechanical forces that trigger biological responses in the periodontium. Therefore, a strong interrelationship exists between orthodontics and periodontology, making it essential to assess the periodontal status both before and during treatment to ensure its success. This study aims to compare the periodontal effects caused by fixed multibracket appliances and clear aligners, considering the biomechanical differences between these systems. The goal is to assess whether there are differences in clinical periodontal parameters between the appliances, particularly in periodontal indices and the occurrence of microbial dysbiosis. Furthermore, the study seeks to determine whether one of these appliances allows for better preservation of periodontal health, with particular attention to patients at increased risk of periodontal disease. Methodology: A review was conducted based on scientific articles published between 2004 and 2024, using databases such as PubMed, Google Scholar, SciELO, ScienceDirect, B-on, and Scopus, as well as the bibliographic collection of the Egas Moniz School of Health & Science library. Only studies conducted on human subjects and published in Portuguese, French, or English were included. Conclusions: Clear aligners tend to be associated with better gingival indices and lower plaque accumulation, mainly due to their removability. However, the available data present methodological limitations and contradictory results. Oral hygiene effectiveness appears to be more decisive for periodontal health than the type of appliance used. Differences in orthodontic force application (continuous vs. intermittent) do not show a significant long-term clinical impact. Therefore, it is not possible to definitively claim the superiority of one system over the other.
Objectives: During orthodontic treatment, teeth are subjected to biomechanical forces that trigger biological responses in the periodontium. Therefore, a strong interrelationship exists between orthodontics and periodontology, making it essential to assess the periodontal status both before and during treatment to ensure its success. This study aims to compare the periodontal effects caused by fixed multibracket appliances and clear aligners, considering the biomechanical differences between these systems. The goal is to assess whether there are differences in clinical periodontal parameters between the appliances, particularly in periodontal indices and the occurrence of microbial dysbiosis. Furthermore, the study seeks to determine whether one of these appliances allows for better preservation of periodontal health, with particular attention to patients at increased risk of periodontal disease. Methodology: A review was conducted based on scientific articles published between 2004 and 2024, using databases such as PubMed, Google Scholar, SciELO, ScienceDirect, B-on, and Scopus, as well as the bibliographic collection of the Egas Moniz School of Health & Science library. Only studies conducted on human subjects and published in Portuguese, French, or English were included. Conclusions: Clear aligners tend to be associated with better gingival indices and lower plaque accumulation, mainly due to their removability. However, the available data present methodological limitations and contradictory results. Oral hygiene effectiveness appears to be more decisive for periodontal health than the type of appliance used. Differences in orthodontic force application (continuous vs. intermittent) do not show a significant long-term clinical impact. Therefore, it is not possible to definitively claim the superiority of one system over the other.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Alinhador transparente Aparelho fixo Movimento dentário ortodôtico Saúde periodontal