Changes in clinical and microbiological parameters of the periodontium during initial stages of orthodontic movement in patients with treated severe periodontitis: A longitudinal site‑level analysis

Abstract

Applying orthodontic braces makes oral hygiene difficult and increases plaque accumulation, frequently resulting in gingival inflammation. In patients with previous severe periodontitis, this inflammation overlaps with the pre-existing inflammatory challenge and can lead to further progression of periodontal attachment loss. The aim of this study was to assess longitudinal site-level changes as mirrored by clinical and microbiological parameters during the initial remodeling of alveolar bone and the periodontal ligament, produced as an effect of light orthodontic forces in adult patients with severe periodontal disease that underwent standard (non-surgical and conventional surgical) periodontal therapy. Thirteen patients with previously treated severe generalized periodontitis were given fixed orthodontic appliances for re-alignment of teeth misaligned or displaced during the course of periodontitis. Before insertion of orthodontic appliances and at 2, 4, and 6 months of treatment, periodontal clinical parameters were recorded in the same deepest residual pocket of at least 3 mm in each patient. The same pocket was sampled at baseline and after 6 months of orthodontic treatment for the frequency of positive detection of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tanerella forsythia (Tf), Treponema denticola (Td). An average reduction in Pocket Depth by 0.2 mm at the end of the assessment period was identified. The only clinical parameter with statistically significant improvement was bleeding on probing. The frequency of detection of Aa, Pg, Pi , and Tf was not significantly different between baseline and 6 months of treatment, while a marginally significant increase of Td was found. There were no significant differences in the clinical parameters or microflora in the initial phase of orthodontic treatment in patients with reduced periodontal support. By correlating clinical and microbiological data, we concluded that the presence of periopathogens do not negatively influence periodontal health during orthodontic treatment in adult patients treated for severe periodontitis.

Finite Element Analysis of Mandibular Anterior Teeth with Healthy, but Reduced Periodontium

“…The orthodontic-periodontal interrelationship is well known and systematically studied [20][21][22], particularly since the reduced periodontium is considered at risk regarding orthodontic treatment [23]; thus, the necessity of studies in this field is justified. This type of periodontium has low resistance to mechanical stress [24].…”

Patologías orales frecuentes en adultos portadores de aparatología ortodóncica fija. Revisión de literatura

“…Según Wu et al (14), en comparación con la aparatología removible, los pacientes tratados con aparatología fija mostraron un aumento en el índice de placa y el índice gingival, además, la profundidad del sondaje periodontal también fue mayor en el grupo de aparatología fija, permitiendo demostrar que los aparatos ortodónticos removibles pueden contribuir a una mejor higiene oral y a la reducción de la acumulación de placa dental (20). Sin embargo, a pesar de estos problemas, se ha demostrado que el tratamiento ortodóncico ya no es una contraindicación para el tratamiento en la periodontitis severa en el adulto y que incluso puede mejorar las posibilidades de salvar y restaurar la dentición deteriorada, pero que en presencia de inflamación la regeneración de estos tejidos se ve detenida (21). En tal contexto, similares resultados presentaron Zasčiurinskiene et al, en el que no se observaron diferencias estadísticamente…”

The Relationship between Dietary Habits and Periodontal Pathogens in a Sample of Romanian Children and Adolescents: A Cross-Sectional Study

“…Additionally, the test is distinguished by its high specificity [10]. Previous research has successfully implemented this test to identify periodontal pathogens in various demographics, including children, adolescents [37,38], pregnant women [24], and diverse adult populations [39,40]. The 11 periodontal pathogens identified through this test have been associated with the onset of periodontal disease.…”