Effects of Malocclusions and Orthodontics on Periodontal Health: Evidence from a Systematic Review

Abstract

Many patients seek orthodontic treatment for esthetic improvement. These patients mostly present with mal-alignment of the anterior teeth. The positive effects of orthodontic treatment on their appearance and self-esteem are easy to envision. However, does orthodontic treatment provide dental health benefits in addition to the esthetic benefits? Do malocclusions harm the periodontium? Is correcting malocclusions with orthodontic treatment beneficial for periodontal health? The purpose of this study is to present evidence available on this topic. Two systematic reviews were conducted to address these questions: does a malocclusion affect periodontal health, and does orthodontic treatment affect periodontal health? Inclusion and exclusion criteria were established for both reviews, and an electronic search and a hand search were conducted. Several papers were included in both reviews, but the overall quality of the studies was weak. The first review found a correlation between the presence of a malocclusion and periodontal disease. Subjects with greater malocclusion have more severe periodontal disease. This may be dependent on oral health status. One should keep in mind that an association does not necessarily mean causation. The second review identified an absence of reliable evidence on the effects of orthodontic treatment on periodontal health. The existing low-quality evidence suggests that orthodontic therapy results in small detrimental effects to the periodontium. The results of both reviews do not warrant recommendation for orthodontic treatment to prevent future periodontal problems, except for specific unusual malocclusions.

Perceptions of outcomes of orthodontic treatment in adolescent patients: a qualitative study

“…Reduction in plaque accumulation and food trapping was another of the dental health subthemes. A participant's inability to maintain oral hygiene and remove plaque in a crowded dentition may be expected, however, there is no strong association between dental irregularities and periodontal disease (23,24). There may, however, be a beneficial effect when treatment is undertaken due to the concomitant oral health related behavioural changes as mentioned previously.…”

Class II:2 malocclusion—prevalence and progression of labial gingival recessions during Herbst-Multibracket appliance treatment

“…The available systematic reviews report both little to no clinically relevant effect [3,4] or small negative effects [5] of orthodontic Tx on periodontal health. Similarly, various investigations have determined a higher prevalence for LGR after orthodontic Tx compared to untreated controls [6,7].…”

Orthodontic treatment need in a group of 6–12-year-old children in Szczecin

“…Orthodontic treatment need can be defined as the degree to which a person needs treatment because of certain features of his or her malocclusion, the functional dental health or aesthetic impairment it occasions, and the negative psychological and social repercussions to which it gives rise [5]. The orthodontic treatment need indices are occlusal criteria used to prioritize a treatment need.…”