The aim of the study was to evaluate the efficacy of oral hygiene procedures in Invisalign and Lingual Orthodontics patients. The study (randomized single blind clinical trial) investigated the efficacy of two different oral hygiene procedures: manual and electronic. The sample consisted of 40 healthy adults patients, 20 being treated with Invisalign and 20 with a Lingual Orthodontics Appliance. The BOP Index and PI were investigated at TO (beginning of treatment) and at T1 (2 months later). Invisalign patients showed better periodontal health (BOP) and a lower plaque index (PI) than STB patients. By the two oral procedures examined, it results that Lingual Group takes advantage in using manual hygiene while Invisalign one in electronic oral hygiene. It appears that, irrespective of the degree of occlusion, which influences the choice of aesthetic appliances, the greater presence of residual plaque in patients treated with a lingual appliances indicates the use of Invisalign in patients at high risk of periodontal disease, as the removeability of this device allows more efficacious plaque removal.