{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:23:36Z","timestamp":1792805016660,"version":"4.5.0"},"reference-count":78,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100014584","name":"Universit\u00e4tsmedizin der Johannes Gutenberg-Universit\u00e4t Mainz","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100014584","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Oral Invest"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>This prospective study aimed to evaluate periodontal inflammation in adolescents undergoing orthodontic treatment with clear aligners (Invisalign\u00ae Teen, Align Technology, San Jose, CA, USA). Key objectives included assessing the presence of 11 periodontitis-associated marker bacteria, active matrix metalloproteinase-8 concentrations in sulcular fluid, and the influence of IL-1 polymorphism genotypes on periodontal health.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>Fifty adolescent patients (13.3\u2009\u00b1\u20091.8\u00a0years) with mixed and permanent dentition participated. Gingival crevicular fluid samples were analyzed at multiple time points: before, during, and one year after aligner treatment. Periodontal health was assessed using the Gingivitis Index and the Modified Quigley-Hein Index. Genotypic analysis of IL-1 polymorphism was also performed. Statistical analyses included mixed linear models and generalized linear models to explore correlations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>All combinations of IL-1 polymorphism genotypes were found in the sample. No significant increase in periodontal inflammation or aMMP-8 concentrations was observed over the treatment period. Marker bacteria from the red and orange-associated complexes remained at low levels, while significant changes occurred in the orange and green complexes, particularly\u00a0Capnocytophaga spp.\u00a0(p\u2009=\u20090.0042) and\u00a0Fusobacterium spp.\u00a0(p\u2009=\u20090.0365). GI correlated significantly with aMMP-8 levels (p\u2009=\u20090.0017), but no genotype effect on GI was observed. MQH showed associations with pathogens from the orange and green complexes, including\u00a0Capnocytophaga spp.\u00a0and\u00a0Fusobacterium spp.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Clear aligner treatment in adolescents, including those with an unfavorable genotype, does not increase periodontal inflammation when accompanied by good oral hygiene.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical relevance<\/jats:title>\n            <jats:p>Regular periodontal monitoring and hygiene reinforcement is important during orthodontic treatment, especially in adolescent patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00784-025-06212-9","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T13:43:56Z","timestamp":1741182236000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Oral health in adolescents: periodontal inflammatory biomarkers during orthodontic clear aligner therapy"],"prefix":"10.1007","volume":"29","author":[{"given":"Carolin","family":"Kredig","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Peuckert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Schmidtmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Drechsler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Erbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"6212_CR1","doi-asserted-by":"publisher","first-page":"369","DOI":"10.14219\/jada.archive.2002.0178","volume":"133","author":"GJ Christensen","year":"2002","unstructured":"Christensen GJ (2002) Orthodontics and the general practitioner. J Am Dent Assoc 133:369\u201371. https:\/\/doi.org\/10.14219\/jada.archive.2002.0178","journal-title":"J Am Dent Assoc"},{"key":"6212_CR2","unstructured":"Tuncay O, Bowman SJ, Amy B, Nicozisis J (2013) Aligner treatment in the teenage patient. J Clin Orthod 47:115\u20139; quiz 140"},{"key":"6212_CR3","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1007\/s00056-015-0285-5","volume":"76","author":"GM Abbate","year":"2015","unstructured":"Abbate GM, Caria MP, Montanari P, Mannu C, Orru G, Caprioglio A, Levrini L (2015) Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances. J Orofac Orthop 76:240\u2013250. https:\/\/doi.org\/10.1007\/s00056-015-0285-5","journal-title":"J Orofac Orthop"},{"key":"6212_CR4","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1186\/s12903-015-0060-4","volume":"15","author":"A Azaripour","year":"2015","unstructured":"Azaripour A, Weusmann J, Mahmoodi B, Peppas D, Gerhold-Ay A, Van Noorden CJ, Willershausen B (2015) Braces versus Invisalign(R): gingival parameters and patients\u2019 satisfaction during treatment: a cross-sectional study. BMC Oral Health 15:69. https:\/\/doi.org\/10.1186\/s12903-015-0060-4","journal-title":"BMC Oral Health"},{"key":"6212_CR5","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/s00056-005-0436-1","volume":"66","author":"RR Miethke","year":"2005","unstructured":"Miethke RR, Vogt S (2005) A comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed orthodontic appliances. J Orofac Orthop 66:219\u2013229. https:\/\/doi.org\/10.1007\/s00056-005-0436-1","journal-title":"J Orofac Orthop"},{"key":"6212_CR6","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1007\/s00056-010-1040-6","volume":"71","author":"I Schaefer","year":"2010","unstructured":"Schaefer I, Braumann B (2010) Halitosis, oral health and quality of life during treatment with Invisalign((R)) and the effect of a low-dose chlorhexidine solution. J Orofac Orthop 71:430\u2013441. https:\/\/doi.org\/10.1007\/s00056-010-1040-6","journal-title":"J Orofac Orthop"},{"key":"6212_CR7","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1111\/idh.12763","volume":"22","author":"C Baumer","year":"2024","unstructured":"Baumer C, Schmidtmann I, Ohlendorf D, Ferrari Peron P, Wehrbein H, Erbe C (2024) Orthodontists\u2019 instructions for oral hygiene in patients with removable and fixed orthodontic appliances. Int J Dent Hyg 22:329\u2013336. https:\/\/doi.org\/10.1111\/idh.12763","journal-title":"Int J Dent Hyg"},{"key":"6212_CR8","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1007\/s00056-007-0655-8","volume":"68","author":"RR Miethke","year":"2007","unstructured":"Miethke RR, Brauner K (2007) A Comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed lingual appliances. J Orofac Orthop 68:223\u2013231. https:\/\/doi.org\/10.1007\/s00056-007-0655-8","journal-title":"J Orofac Orthop"},{"key":"6212_CR9","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1007\/s00056-005-0429-0","volume":"66","author":"V Nedwed","year":"2005","unstructured":"Nedwed V, Miethke RR (2005) Motivation, acceptance and problems of invisalign patients. J Orofac Orthop 66:162\u2013173. https:\/\/doi.org\/10.1007\/s00056-005-0429-0","journal-title":"J Orofac Orthop"},{"key":"6212_CR10","first-page":"186","volume":"21","author":"E Bimstein","year":"1999","unstructured":"Bimstein E, Matsson L (1999) Growth and development considerations in the diagnosis of gingivitis and periodontitis in children. Pediatr Dent 21:186\u2013191","journal-title":"Pediatr Dent"},{"key":"6212_CR11","doi-asserted-by":"publisher","unstructured":"Seeling S, Pr\u00fctz F (2018) Inanspruchnahme kieferorthop\u00e4discher Behandlung durch Kinder und Jugendliche in Deutschland \u2013 Querschnittergebnisse aus KiGGS Welle 2 und Trends. J Health Monit 3:. https:\/\/doi.org\/10.17886\/RKIGBE2018094","DOI":"10.17886\/RKIGBE2018094"},{"key":"6212_CR12","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1007\/s00112-012-2833-z","volume":"161","author":"A Kasaj","year":"2013","unstructured":"Kasaj A, Willershausen B (2013) Periodontal diseases in children and adolescents. Monatsschrift Kinderheilkunde 161:518\u2013523. https:\/\/doi.org\/10.1007\/s00112-012-2833-z","journal-title":"Monatsschrift Kinderheilkunde"},{"key":"6212_CR13","unstructured":"Noack B (2017) Parodontale Erkrankungen bei Kindern und Jugendlichen. In: Zahn\u00e4rzteblatt Sachsen 03\/17. pp 23\u201326.\u00a0https:\/\/www.zahnaerzte-in-sachsen.de\/fileadmin\/Publikationen\/LZKS\/IZZ\/DOKUMENTE\/ZBS\/Fachbeitraege\/2017\/ZBS_03-2017_Parodontale_Erkrankungen_bei_Kindern_und_Jugendlichen.pdf"},{"issue":"Suppl 14","key":"6212_CR14","doi-asserted-by":"publisher","first-page":"S135","DOI":"10.1111\/jcpe.12080","volume":"40","author":"WS Borgnakke","year":"2013","unstructured":"Borgnakke WS, Ylostalo PV, Taylor GW, Genco RJ (2013) Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. J Clin Periodontol 40(Suppl 14):S135\u2013S152. https:\/\/doi.org\/10.1111\/jcpe.12080","journal-title":"J Clin Periodontol"},{"key":"6212_CR15","first-page":"3","volume":"7","author":"TE Van Dyke","year":"2005","unstructured":"Van Dyke TE, Sheilesh D (2005) Risk factors for periodontitis. J Int Acad Periodontol 7:3\u20137","journal-title":"J Int Acad Periodontol"},{"issue":"Suppl 1","key":"6212_CR16","doi-asserted-by":"publisher","first-page":"S46","DOI":"10.1002\/JPER.17-0576","volume":"89","author":"L Trombelli","year":"2018","unstructured":"Trombelli L, Farina R, Silva CO, Tatakis DN (2018) Plaque-induced gingivitis: Case definition and diagnostic considerations. J Periodontol 89(Suppl 1):S46\u2013S73. https:\/\/doi.org\/10.1002\/JPER.17-0576","journal-title":"J Periodontol"},{"key":"6212_CR17","doi-asserted-by":"publisher","first-page":"356","DOI":"10.4103\/jisp.jisp_512_18","volume":"23","author":"RMP Baiju","year":"2019","unstructured":"Baiju RMP, Peter E, Nayar BR, Varughese JM, Varghese NO (2019) Prevalence and predictors of early periodontal disease among adolescents. J Indian Soc Periodontol 23:356\u2013361. https:\/\/doi.org\/10.4103\/jisp.jisp_512_18","journal-title":"J Indian Soc Periodontol"},{"key":"6212_CR18","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1111\/jcpe.13118","volume":"46","author":"O Helal","year":"2019","unstructured":"Helal O, Gostemeyer G, Krois J, Fawzy El Sayed K, Graetz C, Schwendicke F (2019) Predictors for tooth loss in periodontitis patients: Systematic review and meta-analysis. J Clin Periodontol 46:699\u2013712. https:\/\/doi.org\/10.1111\/jcpe.13118","journal-title":"J Clin Periodontol"},{"key":"6212_CR19","doi-asserted-by":"publisher","first-page":"e73","DOI":"10.1111\/idh.12307","volume":"16","author":"HS Luis","year":"2018","unstructured":"Luis HS, Luis LS, Bernardo M, Dos Santos NR (2018) Randomized controlled trial on mouth rinse and flossing efficacy on interproximal gingivitis and dental plaque. Int J Dent Hyg 16:e73\u2013e78. https:\/\/doi.org\/10.1111\/idh.12307","journal-title":"Int J Dent Hyg"},{"key":"6212_CR20","doi-asserted-by":"publisher","first-page":"146","DOI":"10.2319\/031212-217.1","volume":"83","author":"M Karkhanechi","year":"2013","unstructured":"Karkhanechi M, Chow D, Sipkin J, Sherman D, Boylan RJ, Norman RG, Craig RG, Cisneros GJ (2013) Periodontal status of adult patients treated with fixed buccal appliances and removable aligners over one year of active orthodontic therapy. Angle Orthod 83:146\u2013151. https:\/\/doi.org\/10.2319\/031212-217.1","journal-title":"Angle Orthod"},{"key":"6212_CR21","doi-asserted-by":"publisher","first-page":"404","DOI":"10.4103\/1305-7456.163218","volume":"9","author":"L Levrini","year":"2015","unstructured":"Levrini L, Mangano A, Montanari P, Margherini S, Caprioglio A, Abbate GM (2015) Periodontal health status in patients treated with the Invisalign((R)) system and fixed orthodontic appliances: A 3 months clinical and microbiological evaluation. Eur J Dent 9:404\u2013410. https:\/\/doi.org\/10.4103\/1305-7456.163218","journal-title":"Eur J Dent"},{"key":"6212_CR22","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1111\/j.1600-0757.1994.tb00020.x","volume":"5","author":"AD Haffajee","year":"1994","unstructured":"Haffajee AD, Socransky SS (1994) Microbial etiological agents of destructive periodontal diseases. Periodontol 200 5:78\u2013111. https:\/\/doi.org\/10.1111\/j.1600-0757.1994.tb00020.x","journal-title":"Periodontol 200"},{"key":"6212_CR23","unstructured":"Hellwig EKJ, Attin T (2009) Einf\u00fchrung in die Zahnerhaltung; Pr\u00fcfungswissen Kariologie Endodontologie und Parodontologie, Germany"},{"issue":"Suppl 4","key":"6212_CR24","doi-asserted-by":"publisher","first-page":"S203","DOI":"10.1093\/clinids\/16.supplement_4.s203","volume":"16","author":"WJ Loesche","year":"1993","unstructured":"Loesche WJ (1993) Bacterial mediators in periodontal disease. Clin Infect Dis 16(Suppl 4):S203\u2013S210. https:\/\/doi.org\/10.1093\/clinids\/16.supplement_4.s203","journal-title":"Clin Infect Dis"},{"key":"6212_CR25","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1111\/j.1600-051x.1998.tb02419.x","volume":"25","author":"SS Socransky","year":"1998","unstructured":"Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr (1998) Microbial complexes in subgingival plaque. J Clin Periodontol 25:134\u2013144. https:\/\/doi.org\/10.1111\/j.1600-051x.1998.tb02419.x","journal-title":"J Clin Periodontol"},{"key":"6212_CR26","first-page":"206","volume":"63","author":"V Ehlers","year":"2008","unstructured":"Ehlers V, Kasaj A, Prescher N, Willershausen B (2008) Tagungsbeitrag-MMP-8-Messung bei Patienten mit chronischer Parodontitis und Schwangerschaftsgingivitis. Deutsche Zahnarztliche Zeitschrift 63:206","journal-title":"Deutsche Zahnarztliche Zeitschrift"},{"key":"6212_CR27","doi-asserted-by":"publisher","first-page":"1914073","DOI":"10.1155\/2017\/1914073","volume":"2017","author":"MK da Silva","year":"2017","unstructured":"da Silva MK, de Carvalho ACG, Alves EHP, da Silva FRP, Pessoa LDS, Vasconcelos DFP (2017) Genetic factors and the risk of periodontitis development: findings from a systematic review composed of 13 studies of meta-analysis with 71,531 participants. Int J Dent 2017:1914073. https:\/\/doi.org\/10.1155\/2017\/1914073","journal-title":"Int J Dent"},{"key":"6212_CR28","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1034\/j.1600-0765.2000.035002102.x","volume":"35","author":"NP Lang","year":"2000","unstructured":"Lang NP, Tonetti MS, Suter J, Sorrell J, Duff GW, Kornman KS (2000) Effect of interleukin-1 gene polymorphisms on gingival inflammation assessed by bleeding on probing in a periodontal maintenance population. J Periodontal Res 35:102\u2013107. https:\/\/doi.org\/10.1034\/j.1600-0765.2000.035002102.x","journal-title":"J Periodontal Res"},{"key":"6212_CR29","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1111\/jre.12495","volume":"53","author":"EF de Morais","year":"2018","unstructured":"de Morais EF, Pinheiro JC, Leite RB, Santos PPA, Barboza CAG, Freitas RA (2018) Matrix metalloproteinase-8 levels in periodontal disease patients: a systematic review. J Periodontal Res 53:156\u2013163. https:\/\/doi.org\/10.1111\/jre.12495","journal-title":"J Periodontal Res"},{"key":"6212_CR30","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1111\/j.1600-051x.1997.tb01187.x","volume":"24","author":"KS Kornman","year":"1997","unstructured":"Kornman KS, Crane A, Wang HY, di Giovine FS, Newman MG, Pirk FW, Wilson TG Jr, Higginbottom FL, Duff GW (1997) The interleukin-1 genotype as a severity factor in adult periodontal disease. J Clin Periodontol 24:72\u201377. https:\/\/doi.org\/10.1111\/j.1600-051x.1997.tb01187.x","journal-title":"J Clin Periodontol"},{"key":"6212_CR31","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1177\/00220345010800080301","volume":"80","author":"ML Laine","year":"2001","unstructured":"Laine ML, Farre MA, Gonzalez G, van Dijk LJ, Ham AJ, Winkel EG, Crusius JB, Vandenbroucke JP, van Winkelhoff AJ, Pena AS (2001) Polymorphisms of the interleukin-1 gene family, oral microbial pathogens, and smoking in adult periodontitis. J Dent Res 80:1695\u20131699. https:\/\/doi.org\/10.1177\/00220345010800080301","journal-title":"J Dent Res"},{"key":"6212_CR32","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1111\/j.1600-051x.1993.tb00330.x","volume":"20","author":"TE Rams","year":"1993","unstructured":"Rams TE, Oler J, Listgarten MA, Slots J (1993) Utility of Ramfjord index teeth to assess periodontal disease progression in longitudinal studies. J Clin Periodontol 20:147\u2013150. https:\/\/doi.org\/10.1111\/j.1600-051x.1993.tb00330.x","journal-title":"J Clin Periodontol"},{"key":"6212_CR33","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1196\/annals.1384.028","volume":"1098","author":"JS Kinney","year":"2007","unstructured":"Kinney JS, Ramseier CA, Giannobile WV (2007) Oral fluid-based biomarkers of alveolar bone loss in periodontitis. Ann N Y Acad Sci 1098:230\u2013251. https:\/\/doi.org\/10.1196\/annals.1384.028","journal-title":"Ann N Y Acad Sci"},{"key":"6212_CR34","first-page":"532","volume":"21","author":"H Loe","year":"1963","unstructured":"Loe H, Silness J (1963) Periodontal disease in pregnancy, prevalence and severity. Acta Odontol Scand 21:532\u2013551","journal-title":"Acta Odontol Scand"},{"key":"6212_CR35","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1007\/s00056-005-0344-4","volume":"66","author":"C Kossack","year":"2005","unstructured":"Kossack C, Jost-Brinkmann PG (2005) Plaque and gingivitis reduction in patients undergoing orthodontic treatment with fixed appliances-comparison of toothbrushes and interdental cleaning aids. A 6-month clinical single-blind trial. J Orofac Orthop 66:20\u201338. https:\/\/doi.org\/10.1007\/s00056-005-0344-4","journal-title":"J Orofac Orthop"},{"key":"6212_CR36","unstructured":"Brunson JCR, QD (2023) Ggalluvial: Alluvial&xD; plots in & pos; ggplot2 & apos: R package version 0.12.5. https:\/\/corybrunson.github.i.o.\/ggalluvial\/"},{"key":"6212_CR37","unstructured":"dG J (2012) Gebrauchsanleitung dentoELISA aMMP-8 Version 09. https:\/\/dentognostics.de\/uploads\/2012"},{"key":"6212_CR38","doi-asserted-by":"publisher","first-page":"121","DOI":"10.5455\/msm.2022.34.121-125","volume":"34","author":"S Hadzic","year":"2022","unstructured":"Hadzic S, Gojkov-Vukelic M, Pasic E, Jahic IM, Muharemovic A, Redzepagic-Vrazalica L, Jeleskovic A, Nakas E (2022) Evaluation of periodontal changes in patients before, during, and after a fixed orthodontic therapy. Mater Sociomed 34:121\u2013125. https:\/\/doi.org\/10.5455\/msm.2022.34.121-125","journal-title":"Mater Sociomed"},{"key":"6212_CR39","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1186\/s12903-024-03995-3","volume":"24","author":"PF Peron","year":"2024","unstructured":"Peron PF, Wehrbein H, Mundethu A, Schmidtmann I, Erbe C (2024) Clinical parameters and inflammatory biomarkers among patients with multibracket appliances: a prospective clinical trial. BMC Oral Health 24:308. https:\/\/doi.org\/10.1186\/s12903-024-03995-3","journal-title":"BMC Oral Health"},{"key":"6212_CR40","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1902\/jop.2011.110060","volume":"83","author":"A Lee","year":"2012","unstructured":"Lee A, Ghaname CB, Braun TM, Sugai JV, Teles RP, Loesche WJ, Kornman KS, Giannobile WV, Kinney JS (2012) Bacterial and salivary biomarkers predict the gingival inflammatory profile. J Periodontol 83:79\u201389. https:\/\/doi.org\/10.1902\/jop.2011.110060","journal-title":"J Periodontol"},{"key":"6212_CR41","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1046\/j.0906-6713.2002.003424.x","volume":"34","author":"PM Loomer","year":"2004","unstructured":"Loomer PM (2004) Microbiological diagnostic testing in the treatment of periodontal diseases. Periodontology 200 34:49\u201356. https:\/\/doi.org\/10.1046\/j.0906-6713.2002.003424.x","journal-title":"Periodontology 200"},{"issue":"28","key":"6212_CR42","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1034\/j.1600-0757.2002.280102.x","volume":"2000","author":"SS Socransky","year":"2002","unstructured":"Socransky SS, Haffajee AD (2002) Dental biofilms: difficult therapeutic targets. Periodontology 2000(28):12\u201355. https:\/\/doi.org\/10.1034\/j.1600-0757.2002.280102.x","journal-title":"Periodontology"},{"key":"6212_CR43","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1111\/ocr.12427","volume":"24","author":"L Lombardo","year":"2021","unstructured":"Lombardo L, Palone M, Scapoli L, Siciliani G, Carinci F (2021) Short-term variation in the subgingival microbiota in two groups of patients treated with clear aligners and vestibular fixed appliances: A longitudinal study. Orthod Craniofac Res 24:251\u2013260. https:\/\/doi.org\/10.1111\/ocr.12427","journal-title":"Orthod Craniofac Res"},{"issue":"15","key":"6212_CR44","doi-asserted-by":"publisher","first-page":"6758","DOI":"10.3390\/app11156758","volume":"11","author":"MF Sfondrini","year":"2021","unstructured":"Sfondrini MF, Butera A, Di Michele P et al (2021) Microbiological changes during orthodontic aligner therapy: a prospective clinical trial. https:\/\/doi.org\/10.3390\/app11156758","journal-title":"Appl Sci"},{"key":"6212_CR45","doi-asserted-by":"publisher","unstructured":"Ferlazzo N, Curro M, Zinellu A, Caccamo D, Isola G, Ventura V, Carru C, Matarese G, Ientile R (2017) Influence of MTHFR genetic background on p16 and MGMT methylation in oral squamous cell cancer. Int J Mol Sci 18:. https:\/\/doi.org\/10.3390\/ijms18040724","DOI":"10.3390\/ijms18040724"},{"key":"6212_CR46","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1186\/s12903-017-0378-1","volume":"17","author":"R Guo","year":"2017","unstructured":"Guo R, Lin Y, Zheng Y, Li W (2017) The microbial changes in subgingival plaques of orthodontic patients: a systematic review and meta-analysis of clinical trials. BMC Oral Health 17:90. https:\/\/doi.org\/10.1186\/s12903-017-0378-1","journal-title":"BMC Oral Health"},{"key":"6212_CR47","doi-asserted-by":"publisher","first-page":"254","DOI":"10.2319\/030311-156.1","volume":"82","author":"SH Kim","year":"2012","unstructured":"Kim SH, Choi DS, Jang I, Cha BK, Jost-Brinkmann PG, Song JS (2012) Microbiologic changes in subgingival plaque before and during the early period of orthodontic treatment. Angle Orthod 82:254\u2013260. https:\/\/doi.org\/10.2319\/030311-156.1","journal-title":"Angle Orthod"},{"key":"6212_CR48","doi-asserted-by":"publisher","first-page":"e0188420","DOI":"10.1371\/journal.pone.0188420","volume":"12","author":"S Pan","year":"2017","unstructured":"Pan S, Liu Y, Si Y, Zhang Q, Wang L, Liu J, Wang C, Xiao S (2017) Prevalence of fimA genotypes of Porphyromonas gingivalis in adolescent orthodontic patients. PLoS ONE 12:e0188420. https:\/\/doi.org\/10.1371\/journal.pone.0188420","journal-title":"PLoS ONE"},{"key":"6212_CR49","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1016\/j.micpath.2018.08.011","volume":"123","author":"F Sun","year":"2018","unstructured":"Sun F, Ahmed A, Wang L, Dong M, Niu W (2018) Comparison of oral microbiota in orthodontic patients and healthy individuals. Microb Pathog 123:473\u2013477. https:\/\/doi.org\/10.1016\/j.micpath.2018.08.011","journal-title":"Microb Pathog"},{"key":"6212_CR50","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.ajodo.2019.01.026","volume":"157","author":"AN Gujar","year":"2020","unstructured":"Gujar AN, Al-Hazmi A, Raj AT, Patil S (2020) Microbial profile in different orthodontic appliances by checkerboard DNA-DNA hybridization: An in-vivo study. Am J Orthod Dentofacial Orthop 157:49\u201358. https:\/\/doi.org\/10.1016\/j.ajodo.2019.01.026","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"6212_CR51","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1111\/j.1600-051X.1987.tb00979.x","volume":"14","author":"A Diamantikipioti","year":"1987","unstructured":"Diamantikipioti A, Gusberti FA, Lang NP (1987) Clinical and microbiological effects of fixed orthodontic appliances. J Clin Periodontol 14:326\u2013333. https:\/\/doi.org\/10.1111\/j.1600-051X.1987.tb00979.x","journal-title":"J Clin Periodontol"},{"issue":"275","key":"6212_CR52","doi-asserted-by":"publisher","first-page":"e17","DOI":"10.1016\/j.ajodo.2005.10.022","volume":"130","author":"AA Naranjo","year":"2006","unstructured":"Naranjo AA, Trivino ML, Jaramillo A, Betancourth M, Botero JE (2006) Changes in the subgingival microbiota and periodontal parameters before and 3 months after bracket placement. Am J Orthod Dentofacial Orthop 130(275):e17-22. https:\/\/doi.org\/10.1016\/j.ajodo.2005.10.022","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"6212_CR53","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1111\/j.1601-5037.2008.00283.x","volume":"6","author":"M Ristic","year":"2008","unstructured":"Ristic M, Vlahovic Svabic M, Sasic M, Zelic O (2008) Effects of fixed orthodontic appliances on subgingival microflora. Int J Dent Hyg 6:129\u2013136. https:\/\/doi.org\/10.1111\/j.1601-5037.2008.00283.x","journal-title":"Int J Dent Hyg"},{"key":"6212_CR54","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.ajodo.2007.02.057","volume":"135","author":"MJ Thornberg","year":"2009","unstructured":"Thornberg MJ, Riolo CS, Bayirli B, Riolo ML, Van Tubergen EA, Kulbersh R (2009) Periodontal pathogen levels in adolescents before, during, and after fixed orthodontic appliance therapy. Am J Orthod Dentofacial Orthop 135:95\u201398. https:\/\/doi.org\/10.1016\/j.ajodo.2007.02.057","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"6212_CR55","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/s00056-010-0001-4","volume":"72","author":"C Erbe","year":"2011","unstructured":"Erbe C, Hornikel S, Schmidtmann I, Wehrbein H (2011) Quantity and distribution of plaque in orthodontic patients treated with molar bands. J Orofac Orthop 72:13\u201320. https:\/\/doi.org\/10.1007\/s00056-010-0001-4","journal-title":"J Orofac Orthop"},{"key":"6212_CR56","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1007\/s00430-015-0413-2","volume":"204","author":"S Izadi Borujeni","year":"2015","unstructured":"Izadi Borujeni S, Mayer M, Eickholz P (2015) Activated matrix metalloproteinase-8 in saliva as diagnostic test for periodontal disease? A case-control study. Med Microbiol Immunol 204:665\u2013672. https:\/\/doi.org\/10.1007\/s00430-015-0413-2","journal-title":"Med Microbiol Immunol"},{"key":"6212_CR57","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1093\/ejo\/cjh097","volume":"27","author":"T Ingman","year":"2005","unstructured":"Ingman T, Apajalahti S, Mantyla P, Savolainen P, Sorsa T (2005) Matrix metalloproteinase-1 and -8 in gingival crevicular fluid during orthodontic tooth movement: a pilot study during 1 month of follow-up after fixed appliance activation. Eur J Orthod 27:202\u2013207. https:\/\/doi.org\/10.1093\/ejo\/cjh097","journal-title":"Eur J Orthod"},{"key":"6212_CR58","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1177\/154405910308201216","volume":"82","author":"S Apajalahti","year":"2003","unstructured":"Apajalahti S, Sorsa T, Railavo S, Ingman T (2003) The in vivo levels of matrix metalloproteinase-1 and -8 in gingival crevicular fluid during initial orthodontic tooth movement. J Dent Res 82:1018\u20131022. https:\/\/doi.org\/10.1177\/154405910308201216","journal-title":"J Dent Res"},{"key":"6212_CR59","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1093\/ejo\/cjs053","volume":"35","author":"C Canavarro","year":"2013","unstructured":"Canavarro C, Teles RP, Capelli Junior J (2013) Matrix metalloproteinases -1, -2, -3, -7, -8, -12, and -13 in gingival crevicular fluid during orthodontic tooth movement: a longitudinal randomized split-mouth study. Eur J Orthod 35:652\u2013658. https:\/\/doi.org\/10.1093\/ejo\/cjs053","journal-title":"Eur J Orthod"},{"key":"6212_CR60","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.2319\/101714-744.1","volume":"85","author":"RC Almeida","year":"2015","unstructured":"Almeida RC, Capelli J Jr, Teles RP (2015) Levels of gingival crevicular fluid matrix metalloproteinases in periodontally compromised teeth under orthodontic forces. Angle Orthod 85:1009\u20131014. https:\/\/doi.org\/10.2319\/101714-744.1","journal-title":"Angle Orthod"},{"key":"6212_CR61","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1093\/ejo\/cjn127","volume":"31","author":"MM Bildt","year":"2009","unstructured":"Bildt MM, Bloemen M, Kuijpers-Jagtman AM, Von den Hoff JW (2009) Matrix metalloproteinases and tissue inhibitors of metalloproteinases in gingival crevicular fluid during orthodontic tooth movement. Eur J Orthod 31:529\u2013535. https:\/\/doi.org\/10.1093\/ejo\/cjn127","journal-title":"Eur J Orthod"},{"key":"6212_CR62","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1111\/jre.12850","volume":"56","author":"P Pani","year":"2021","unstructured":"Pani P, Tsilioni I, McGlennen R, Brown CA, Hawley CE, Theoharides TC, Papathanasiou E (2021) IL-1B(3954) polymorphism and red complex bacteria increase IL-1beta (GCF) levels in periodontitis. J Periodontal Res 56:501\u2013511. https:\/\/doi.org\/10.1111\/jre.12850","journal-title":"J Periodontal Res"},{"key":"6212_CR63","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1902\/jop.2009.090397","volume":"81","author":"R Teles","year":"2010","unstructured":"Teles R, Sakellari D, Teles F, Konstantinidis A, Kent R, Socransky S, Haffajee A (2010) Relationships among gingival crevicular fluid biomarkers, clinical parameters of periodontal disease, and the subgingival microbiota. J Periodontol 81:89\u201398. https:\/\/doi.org\/10.1902\/jop.2009.090397","journal-title":"J Periodontol"},{"key":"6212_CR64","doi-asserted-by":"publisher","first-page":"e475","DOI":"10.1016\/j.ajodo.2021.10.015","volume":"161","author":"B Shokeen","year":"2022","unstructured":"Shokeen B, Viloria E, Duong E, Rizvi M, Murillo G, Mullen J, Shi B, Dinis M, Li H, Tran NC, Lux R, Wu T (2022) The impact of fixed orthodontic appliances and clear aligners on the oral microbiome and the association with clinical parameters: A longitudinal comparative study. Am J Orthod Dentofacial Orthop 161:e475\u2013e485. https:\/\/doi.org\/10.1016\/j.ajodo.2021.10.015","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"6212_CR65","doi-asserted-by":"publisher","first-page":"e64396","DOI":"10.7759\/cureus.64396","volume":"16","author":"MA Al-Mutairi","year":"2024","unstructured":"Al-Mutairi MA, Al-Salamah L, Nouri LA, Al-Marshedy BS, Al-Harbi NH, Al-Harabi EA, Al-Dosere HA, Tashkandi FS, Al-Shabib ZM, Altalhi AM (2024) Microbial changes in the periodontal environment due to orthodontic appliances: a review. Cureus 16:e64396. https:\/\/doi.org\/10.7759\/cureus.64396","journal-title":"Cureus"},{"key":"6212_CR66","first-page":"35","volume":"2","author":"A Barlattani Jr","year":"2009","unstructured":"Barlattani A Jr, Mampieri G, Ottria L, Bollero P (2009) Invisalign treatment in periodondal patient: case report. Oral Implantol 2:35","journal-title":"Oral Implantol"},{"key":"6212_CR67","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1053\/sodo.2001.25414","volume":"7","author":"RL Boyd","year":"2001","unstructured":"Boyd RL, Waskalic V (2001) Three-dimensional diagnosis andorthodontic treatment of complex malocclusions with the invisalign appliance. Semin Orthod 7:274\u2013293","journal-title":"Semin Orthod"},{"key":"6212_CR68","doi-asserted-by":"publisher","first-page":"e0248","DOI":"10.1097\/MD.0000000000010248","volume":"97","author":"H Lu","year":"2018","unstructured":"Lu H, Tang H, Zhou T, Kang N (2018) Assessment of the periodontal health status in patients undergoing orthodontic treatment with fixed appliances and Invisalign system: A meta-analysis. Medicine (Baltimore) 97:e0248. https:\/\/doi.org\/10.1097\/MD.0000000000010248","journal-title":"Medicine (Baltimore)"},{"key":"6212_CR69","doi-asserted-by":"publisher","unstructured":"Partouche AJD, Castro F, Baptista AS, Costa LG, Fernandes JCH, Fernandes GVO (2022) Effects of multibracket orthodontic treatment versus clear aligners on periodontal health: an integrative review. Dent J (Basel) 10: https:\/\/doi.org\/10.3390\/dj10100177","DOI":"10.3390\/dj10100177"},{"key":"6212_CR70","doi-asserted-by":"publisher","first-page":"e23165","DOI":"10.1097\/MD.0000000000023165","volume":"99","author":"Y Wu","year":"2020","unstructured":"Wu Y, Cao L, Cong J (2020) The periodontal status of removable appliances vs fixed appliances: A comparative meta-analysis. Medicine (Baltimore) 99:e23165. https:\/\/doi.org\/10.1097\/MD.0000000000023165","journal-title":"Medicine (Baltimore)"},{"key":"6212_CR71","doi-asserted-by":"publisher","unstructured":"Di Spirito F, D\u2019Ambrosio F, Cannata D, D'Anto V, Giordano F, Martina S (2023) Impact of clear aligners versus fixed appliances on periodontal status of patients undergoing orthodontic treatment: a systematic review of systematic reviews. Healthcare (Basel) 11:. https:\/\/doi.org\/10.3390\/healthcare11091340","DOI":"10.3390\/healthcare11091340"},{"key":"6212_CR72","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1093\/ejo\/cju083","volume":"37","author":"G Rossini","year":"2015","unstructured":"Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL (2015) Periodontal health during clear aligners treatment: a systematic review. Eur J Orthod 37:539\u2013543. https:\/\/doi.org\/10.1093\/ejo\/cju083","journal-title":"Eur J Orthod"},{"key":"6212_CR73","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1111\/odi.13175","volume":"26","author":"R Zhao","year":"2020","unstructured":"Zhao R, Huang R, Long H, Li Y, Gao M, Lai W (2020) The dynamics of the oral microbiome and oral health among patients receiving clear aligner orthodontic treatment. Oral Dis 26:473\u2013483. https:\/\/doi.org\/10.1111\/odi.13175","journal-title":"Oral Dis"},{"key":"6212_CR74","doi-asserted-by":"publisher","first-page":"e2321124","DOI":"10.1590\/2177-6709.28.1.e2321124.oar","volume":"28","author":"R Favero","year":"2023","unstructured":"Favero R, Libralato L, Balestro F, Volpato A, Favero L (2023) Edge level of aligners and periodontal health: a clinical perspective study in young patients. Dental Press J Orthod 28:e2321124. https:\/\/doi.org\/10.1590\/2177-6709.28.1.e2321124.oar","journal-title":"Dental Press J Orthod"},{"key":"6212_CR75","doi-asserted-by":"publisher","unstructured":"Traversa F, Chavanne P, Mah J (2024) Biomechanics of clear aligner therapy: Assessing the influence of tooth position and flat trimline height in translational movements. Orthod Craniofac Res:. https:\/\/doi.org\/10.1111\/ocr.12796","DOI":"10.1111\/ocr.12796"},{"key":"6212_CR76","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1186\/s12903-024-05063-2","volume":"24","author":"W Chen","year":"2024","unstructured":"Chen W, Chen J, Bai D, Wang P, Shu R (2024) Effects of clear aligners and traditional removable appliances on oral microbiome in mixed dentition: a comparative study. BMC Oral Health 24:1276. https:\/\/doi.org\/10.1186\/s12903-024-05063-2","journal-title":"BMC Oral Health"},{"key":"6212_CR77","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1111\/j.1600-051x.1985.tb00926.x","volume":"12","author":"T Arendorf","year":"1985","unstructured":"Arendorf T, Addy M (1985) Candidal carriage and plaque distribution before, during and after removable orthodontic appliance therapy. J Clin Periodontol 12:360\u2013368. https:\/\/doi.org\/10.1111\/j.1600-051x.1985.tb00926.x","journal-title":"J Clin Periodontol"},{"key":"6212_CR78","first-page":"55","volume":"20","author":"S Petti","year":"1997","unstructured":"Petti S, Barbato E, Simonetti D\u2019Arca A (1997) Effect of orthodontic therapy with fixed and removable appliances on oral microbiota: a six-month longitudinal study. New Microbiol 20:55\u201362","journal-title":"New Microbiol"}],"container-title":["Clinical Oral Investigations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-025-06212-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00784-025-06212-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-025-06212-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T04:56:47Z","timestamp":1742705807000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00784-025-06212-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,5]]},"references-count":78,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["6212"],"URL":"https:\/\/doi.org\/10.1007\/s00784-025-06212-9","relation":{},"ISSN":["1436-3771"],"issn-type":[{"value":"1436-3771","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,5]]},"assertion":[{"value":"29 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 February 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of the Medical Chamber of Rhineland Palatinate (9565; 2014.08.20).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all subjects involved in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"168"}}