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Periodontal patients may face orthodontic problems because of bone support loss, such as maxillary incisor proclination, spacing, rotation, extrusion, pathologic tooth migration (PTM) or traumatic occlusion. Orthodontic treatment is therefore an element within the comprehensive treatment of periodontitis after the periodontal condition has stabilized. The presence of fixed appliances (FAs) promotes the accumulation of bacterial biofilm and impedes hygiene procedures. The increasing popularity of clear aligner (CA) treatment is due to the convenience of use, less discomfort, better esthetics, easier hygiene, lower failure rate, and shorter, less frequent visits. Therefore, the question arises whether treatment with aligners is a good solution for periodontal patients. To answer this question, the PubMed/Medline, Cochrane Library and EMBASE databases were searched using the following keywords: periodontitis, orthodontic treatment, clear aligners, multibracket orthodontic appliances, fixed appliance, root resorption, gingival recession and pathologic tooth migration. The search strategy identified 18 relevant studies. A total of 1090 participants took part in the analyzed studies. The available literature was analyzed in terms of the occurrence of root apex resorption, the possibility of treating pathologic tooth migration, the occurrence of gingival recession, periodontal health status and occlusal stability in patients treated with CAs and FAs. Despite statistically significant differences in terms of Plaque Index (PI), probing depth (PD), apical root resorption and gingival recession favor the use of CAs. However, these values are mostly of no clinical significance. It is possible to treat PTM with CAs, but it is limited by the high degree of tooth mobility and incisor inclination. Obtaining perfect occlusion is comparably difficult in both CA and FA treatment. When planning orthodontic treatment in patients with reduced periodontium, the use of both CAs and FAs should be considered. The choice of method would ultimately depend on the patient's dental condition. [ABSTRACT FROM AUTHOR]

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Introduction: The aim of the study was to identify the periodontal status of Szczecin citizens using the Community Periodontal Index (CPI), and to compare the results with those from selected European and world countries using the World Health Organization (WHO) database., Material and Methods: A sample of 250 patients was randomly selected using two-stage stratified sampling among people living in Szczecin aged 35-44 years. Participants were examined using the WHO CPI score at the Department of Periodontology, Pomeranian Medical University in Szczecin. Scores were compared with findings from previous research carried out in Poland and other countries., Results: That only 4.4% of respondents had a healthy periodontium (5.76% of women and only 2.7% of men). Bleeding gums after probing (17.99%) and the presence of calculus (20.14%) were more frequently reported in women. The largest percentage of respondents (44.8%) had periodontal pockets 3.5-5.5 mm deep, with more women (45.32%) than men (44.14%). In contrast, more men (25.23%) had deep periodontal pockets at least 6 mm deep, with only 10.79% in women. A survey conducted across Poland in 1987 showed 0.7% of people with a healthy periodontium which rose to 6.3% in 1995. Compared to studies available in the WHO database, the number of people with a healthy periodontium, i.e. CPI = 0 is lower than in Japan (18%) and Spain (15%), but higher than in the United Kingdom (4%) and China (0%)., Conclusions: Findings from the study indicate an increasing percentage of people in Poland suffering from periodontal disease. This brings us closer to results obtained in developed countries around the world.