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].…”

Ortodontinio Gydymo Įtaka Pažeistiems Periodonto Audiniams

“…Periodontitu sergančių suaugusių pacientų periodonto audiniuose per pirmas šešias ortodontinio gydymo savaites pastebimas reikšmingas periodontologines ligas skatinančių patogenų Campylobacter rectus, Veilonella, Peptostreptococcus, Actinomyces viscosus, Bacterionema rothia skaičius, tačiau, esant tinkamai periodonto audinių sveikatos priežiūrai, jis išlieka stabilus ir aktyvios periodonto ligos nesukelia [9]. Kiti in vivo tyrimų autoriai taip pat pastebi, kad atsakingai kontroliuojant periodontitu sergančio paciento periodonto audinių būklę ortodontinio gydymo metu, uždegiminiai ir mikrobiologiniai pokyčiai nedaro neigiamo poveikio periodonto sveikatai: A. actinomycetemcomitans, P. gingivalis, T. forsythia ir T. dentincola bakterijų skaičius per pirmąjį ortodontinio gydymo pusmetį ir matrikso metalo proteinazių kiekis dantenų vagelės skystyje 21 dienos laikotarpiu reikšmingai nedidėja, o kraujavimas po zondavimo, ortodontinio gydymo pradžioje galintis siekti 90 proc., po 4-6 ortodontinio gydymo mėnesių sumažėja iki 20 procentų [10,11].…”