Comparative Analysis of Periodontal Tissue Status During Orthodontic Treatment With Aligners and Vestibular Bracket Systems

The relevance of this study is driven by the increasing prevalence of orthodontic treatment among the adult population and the need to ensure not only functional and esthetic outcomes but also the preservation of periodontal health as a key determinant of long-term treatment stability. The expanding use of aligners alongside traditional vestibular bracket systems underscores the need for a scientifically grounded comparative analysis of their effects on periodontal tissues, as existing evidence remains fragmented and clinical outcomes are inconsistent. The aim of this study is to determine the specific features of changes in periodontal tissue status in patients undergoing orthodontic treatment depending on the type of ortho­dontic appliance and to substantiate approaches for minimizing periodontal risks. Results. The baseline condition of periodontal tissues was assessed, revealing that a substantial proportion of patients initiate orthodontic treatment with initial inflammatory changes in the absence of clinical signs of tissue destruction. It was established that during treatment, the type of orthodontic appliance determines different dynamics of perio­dontal parameters. The use of aligners was shown to be associated with moderate and predominantly transient changes, whereas vestibular bracket systems were linked to persistent dental plaque accumulation and prolonged elevation of gingival indices. It was experimentally confirmed that the first months of orthodontic treatment represent the most critical period for the development of inflammatory changes. Conclusions. Periodontal risks associated with orthodontic treatment were found to have not only a behavioral but also an appliance-related nature. The feasibility of a differentiated selection of orthodontic appliances and the intensification of preventive support at the early stages of treatment was substantiated. Prospects for further research include the evaluation of the long-term impact of chronic inflammatory changes in periodontal tissues on the stability of orthodontic outcomes and the development of individualized preventive protocols that take into account the type of orthodontic appliance and patient risk profiles.