Background: This was a comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis. Material and methods:A cohort of 50 patients, comprising 20 males and 30 females, who received orthodontic treatment, was evaluated for participation in this study. The criteria for inclusion specified that patients must have chronic periodontitis characterized by more than 2 mm of attachment loss and probing pocket depths exceeding 3 mm. All participants were in satisfactory general health, exhibiting no indications of systemic illness. Notably, all but one patient were non-smokers. Additional exclusion criteria included the presence of active infections, conditions that could impair bone metabolism or wound healing, a history of radiation therapy to the head or neck, regular use of steroids or other medications that influence bone turnover, and pregnancy. Each patient exhibited minor malalignment of incisors or pathological movement of the maxillary or mandibular incisors, without signs of posterior bite collapse. From the outset of treatment planning, all cases were reviewed with an orthodontist from the Department of Orthodontics, ensuring that the primary needs of the patients were thoroughly considered. For diagnostic purposes, study casts were replicated, and the misaligned or pathologically displaced teeth were meticulously excised from the model. These teeth were subsequently repositioned in an ideal alignment using wax. Following scaling and root planning, along with ongoing education on mechanical supragingival plaque control, each patient underwent a re-evaluation. In instances where oral hygiene was deemed inadequate (plaque index >1.5), further education on oral hygiene practices and periodontal treatment was provided prior to the initiation of orthodontic therapy. Upon completion of the initial periodontal intervention, minor movements of the anterior teeth were performed. Except for those patients who required fixed appliances due to significant labial inclinations or mobility of anterior teeth, the selection of orthodontic appliances was based on patient preference, following comprehensive discussions regarding the benefits and drawbacks of the two methods. Statistical analyses were performed utilizing SPSS software. Results:In this study, there were 50 subjects of which 25 received fixed appliance treatment and 25 received clear aligner treatment. There were 50 subjects of which 20 were male and 30 were female. Mandible was involved in total 35 cases. 19 fixed appliance cases were evident in mandible and 6 fixed appliance cases were of maxilla. Clear alignment treatment was done in 9 maxillary arch and 16 mandibular arches. The duration of treatment for fixed appliance was 4.27±1.83 months and the duration of treatment of clear aligners was 6.98±2.25 months. The baseline plaque index of the subjects of fixed appliance group was 1.51±0.76 and the post-treatment value of plaque index in the same group was 1.03±0.19. The baseline plaque index of the subjects of clear aligner group was 1.32±0.38 and the post-treatment value of plaque index in the same group was 1.04±0.24. The baseline plaque index of the subjects of clear aligner group was 0.61±0.12 and the post-treatment value of plaque index in the same group was 0.51±0.18. The baseline plaque index of the subjects of clear aligner group was 0.59±0.23 and the post-treatment value of plaque index in the same group was 0.42±0.11. Conclusion:Following orthodontic treatment, there was a notable enhancement in clinical parameters within both the fixed appliance and clear alignment treatment groups, attributed to comprehensive oral hygiene education and effective plaque management. When examining the plaque index and gingival index, no significant disparities were observed between the two groups. It is proposed that an integrated approach to periodontal and orthodontic treatment can enhance the periodontal health of patients, regardless of the specific orthodontic methods employed.