How Does Orthodontic Treatment Impact Periodontal Health?

The objective of a recent prospective, randomized, controlled clinical trial was to assess the impact of fixed orthodontic treatment on periodontal parameters in adult patients with compromised periodontal health. A total of 36 adult patients with periodontal issues, with a mean age of 29.67 ± 4.8 years, were randomly assigned to either the test group (perio-ortho) or the control group (perio).

Both groups underwent periodontal stabilization before the start of the study. The test group then began orthodontic treatment, while the control group continued with periodontal maintenance only. The clinical parameters evaluated and compared between the groups included plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL). These parameters were assessed at three time intervals: T0 (baseline), T1 (start of orthodontic treatment), and T2 (1 year after the start of orthodontic treatment). Additionally, radiological parameters, specifically alveolar bone levels (ABL), were measured using cone-beam computed tomography (CBCT) at T1 and T2.

The results of the study showed statistically significant improvement in all clinical and radiological periodontal parameters within both the test and control groups (P ≤ .05). However, when comparing the two groups, there was no statistically significant difference in the improvement of periodontal parameters (P ≥ .05). Subgroup analysis revealed a reduction in the number of moderate and severe periodontitis sites in both groups. Interestingly, the test group showed significant gains in ABL compared to the control group.

Based on these findings, the study concluded that orthodontic treatment following periodontal stabilization does not have a negative impact on periodontal health in adult orthodontic patients with compromised periodontal conditions. Furthermore, orthodontic treatment may provide additional benefits beyond those achieved by periodontal treatment alone. The study suggests that orthodontic intervention can be safely performed in such patients without detrimental effects on their periodontal health.

It is important to note that this study had certain limitations, such as its small sample size and the relatively short follow-up period of 1 year. Future research with larger sample sizes and longer-term follow-up periods could provide further insights into the effects of orthodontic treatment on periodontal health in periodontally compromised adult patients.

Reference:

Gehlot M, Sharma R, Tewari S, Kumar D, Gupta A. Effect of orthodontic treatment on periodontal health of periodontally compromised patients. Angle Orthod. 2022;92(3):324-332. doi:10.2319/022521-156.1