Orthodontic treatment can have significant effects on periodontal health, with concerns over plaque accumulation, gingival inflammation, and periodontal status. This randomized controlled trial (RCT) evaluates the impact of clear aligners versus fixed braces on periodontal health over a six-month period. A total of 120 participants were enrolled and randomly assigned to either the clear aligner group (n=60) or the fixed braces group (n=60). Periodontal health parameters, including plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (CAL), were assessed at baseline, three months, and six months. The results demonstrated significantly lower PI and GI scores in the clear aligner group at three and six months compared to the fixed braces group (p<0.05), indicating superior oral hygiene maintenance with aligners. Probing depth and CAL were not significantly different between groups at baseline but showed greater deterioration in the fixed braces group at follow-ups (p<0.05). These findings suggest that clear aligners have a more favorable impact on periodontal health compared to fixed braces, primarily due to easier oral hygiene maintenance. This study emphasizes the need for individualized periodontal monitoring during orthodontic treatment and supports the use of clear aligners for patients with periodontal susceptibility.