Impact of Orthodontic Treatment on Periodontal Tissues: A Narrative Review of Multidisciplinary Literature

Abstract

The aim of this review is to describe the most commonly observed changes in periodontium caused by orthodontic treatment in order to facilitate specialists' collaboration and communication. An electronic database search was carried out using PubMed abstract and citation database and bibliographic material was then used in order to find other appropriate sources. Soft and hard periodontal tissues changes during orthodontic treatment and maintenance of the patients are discussed in order to provide an exhaustive picture of the possible interactions between these two interwoven disciplines.

A retrospective study of orthodontic treatment with pre-treatment gingival recessions

“…An etiologic factor of the recession was classi ed to labial tooth position due to crowding, labial/buccal root inclination and unfavourable occlusal contacts with antagonist teeth (Table 3) [12]. Interestingly, GR improvements were somewhat similar despite etiologic factor suggesting that recession improvement may be due to correction of malocclusion, the better position of tooth roots in the alveolar envelope by lingually moving labially positioned teeth, or tooth roots (by changing inclination) and also resolving unfavourable occlusal contacts [12,22]. Therefore orthodontic movements should be carefully planned before the orthodontic treatment to reach the aforementioned results, knowing that the main key is trying to retain the roots within the alveolar bony envelope [28,43].…”

“…As untreated malocclusions have also been found to in uence gingival problems (including GR), orthodontic therapy may favour tooth positions and be advantageous in the interdisciplinary treatment plan of GR management [21]. It has been described in the literature that moving a facially positioned tooth or its root in the lingual direction to a more centred position within the alveolar process, the apico-coronal dimension of gingival tissue will increase in width [2,22].…”

Prospective Clinical Investigation of Orthodontic Relapse from Gingival Clefts

“…A graphical representation of thin vs. thick gingival phenotype and the incidence of relapse associated with each is show in (Graph 1). Of those sites in the thin gingival group the mean cleft severity was 7.63 mm 2 , and of those sites in the thick gingival group the mean cleft severity was 12.00 mm 2 .…”

“…Premolar extraction followed by space closure mechanics is common practice in orthodontics treatment [1]. A consequence of moving teeth to close space is the formation of an invagination in the gingiva, which is also called a gingival cleft [2][3][4]. These gingival clefts may delay or even prevent space closure, as well as contribute to relapse of closed extraction spaces after orthodontic treatment is completed [5,6].…”

“…When looking at the periodontium, the most common occurring changes in orthodontic extraction cases are gingival recession, gingival overgrowth, and gingival invaginations ( Figure 1). [2,8]. Due to the compression and retraction forces at sites of extraction the interdental papillae may enlarge and accumulate resulting in gingival invaginations [9,10].…”