Orthodontic treatment in periodontitis‐susceptible subjects: a systematic literature review

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Abstract

The aim is to evaluate the literature for clinical scientific data on possible effects of orthodontic treatment on periodontal status in periodontitis‐susceptible subjects. A systematic literature review was performed on studies in English using PubMed, MEDLINE, and Cochrane Library central databases (1965‐2014). By manually searching reference lists of selected studies, we identified additional articles; then we searched these publications: Journal of Periodontology, Periodontology 2000, Journal of Clinical Periodontology, American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, International Journal of Periodontics & Restorative Dentistry, and European Journal of Orthodontics. Search terms included randomized clinical trials, controlled clinical trials, prospective and retrospective clinical studies, case series >5 patients, periodontitis, orthodontics, alveolar bone loss, tooth migration, tooth movement, orthodontic extrusion, and orthodontic intrusion. Only studies on orthodontic treatment in periodontally compromised dentitions were included. One randomized controlled clinical trial, one controlled clinical trial, and 12 clinical studies were included. No evidence currently exists from controlled studies and randomized controlled clinical trials, which shows that orthodontic treatment improves or aggravates the status of periodontally compromised dentitions.

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Most cited references 45

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The pathogenesis of human periodontitis: an introduction.

R C Page, K Kornman (1997)

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Mapping the pathogenesis of periodontitis: a new look.

Kenneth S Kornman (2008)

Chronic adult periodontitis is a bacterially induced chronic inflammatory disease that destroys the connective tissue and bone that support teeth. Concepts of the specific mechanisms involved in the disease have evolved with new technologies and knowledge. Histopathologic observations of diseased human tissues were used previously to speculate on the causes of periodontitis and to describe models of pathogenesis. Experimental evidence later emerged to implicate bacterial plaque deposits as the primary factor initiating periodontitis. At the same time, specific bacteria and immunoinflammatory mechanisms were differentially implicated in the disease. In the mid-1990s, early insights about complex diseases, such as periodontitis, led to new conceptual models of the pathogenesis of periodontitis. Those models included the bacterial activation of immunoinflammatory mechanisms, some of which targeted control of the bacterial challenge and others that had adverse effects on bone and connective tissue remodeling. Such models also acknowledged that different environmental and genetic factors modified the clinical phenotype of periodontal disease. However, the models did not capture the dynamic nature of the biochemical processes, i.e., that innate differences among individuals and changes in environmental factors may accelerate biochemical changes or dampen that shift. With emerging genomic, proteomic, and metabolomic data and systems biology tools for interpreting data, it is now possible to begin describing the basic elements of a new model of pathogenesis. Such a model incorporates gene, protein, and metabolite data into dynamic biologic networks that include disease-initiating and -resolving mechanisms. This type of model has a multilevel framework in which the biochemical networks that are regulated by innate and environmental factors can be described and the interrelatedness of networks can be captured. New models in the next few years will be merely frameworks for integrating key knowledge as it becomes available from the "-omics" technologies. However, it is possible to describe some of the key elements of the new models and discuss distinctions between the new and older models. It is hoped that improved conceptual models of pathogenesis will assist in focusing new research and speed the translation of new data into practical applications.

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Some periodontal tissue reactions to orthodontic tooth movement in monkeys.

J Wennström, F Sinclair, J Lindhe … (1987)

The purpose of the experiment reported was to study soft tissue changes at teeth which were orthodontically moved into areas with varying thickness and quality of periodontal tissues. The maxillary central incisors and first premolars in 5 adult monkeys were used as experimental teeth. 6 months prior to the start of the orthodontic treatment phase, the maxillary second premolars were extracted. By surgical means, areas with varying width of the keratinized gingiva were established in the incisor and premolar region. Following a clinical baseline examination which involved assessments of gingival width, location of the gingival margin in relation to cemento-enamel junction and probing attachment level, fixed orthodontic appliances were inserted in order to bodily move the two contral incisors in labial direction through the alveolar bone envelope and the first premolars in distal direction into contact with the first molars. Orthodontic forces were applied for a period of 3-4 months. The lateral incisors and first molars were selected as non-moved control teeth. After the experimental teeth had been retained in their new positions for 1 month, the clinical examination was repeated. Tissue blocks containing test and control specimens were subsequently dissected and prepared for microscopic analysis. The analysis included histometric assessments of loss of connective tissue attachment and height of alveolar bone. The results showed that at every second labially moved incisor, the gingival margin had become displaced in apical direction. The degree of displacement, however, was small and only at 2 teeth accompanied by loss of connective tissue attachment. Throughout the study, these particular teeth also showed obvious signs of gingival inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)

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Author and article information

Contributors

Egle Zasciurinskiene: eglezas@gmail.com

Journal

Journal ID (nlm-ta): Clin Exp Dent Res

Journal ID (iso-abbrev): Clin Exp Dent Res

Journal ID (doi): 10.1002/(ISSN)2057-4347

Journal ID (publisher-id): CRE2

Title: Clinical and Experimental Dental Research

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Electronic): 2057-4347

Publication date (Electronic): 21 April 2016

Publication date Collection: November 2016

Volume: 2

Issue: 2 ( doiID: 10.1002/cre2.v2.2 )

Pages: 162-173

Affiliations

[ ¹ ] Department of Orthodontics, Medical Academy Lithuanian University of Health Sciences Kaunas Lithuania

[ ² ] School of Health Sciences Jönköping University Jönköping Sweden

[ ³ ] Department of Orthodontics Institute for Postgraduate Dental Education Jönköping Sweden

[ ⁴ ] Department of Periodontology Institute for Postgraduate Dental Education Jönköping Sweden

[ ⁵ ] Department of Biomaterials, Institute for Clinical Sciences, Sahlgrenska Academy University of Gothenburg Göteborg Sweden

Author notes

[*] [* ] Correspondence

Egle Zasciurinskiene, Department of Orthodontics, Lithuanian University of Health Sciences, Luksos‐Daumanto 6, LT‐50106, Kaunas, Lithuania.

E‐mail: eglezas@ 123456gmail.com

Article

Publisher ID: CRE228 Other ID: CRE2.20150067.R1

DOI: 10.1002/cre2.28

PMC ID: 5839229

PubMed ID: 29744163

SO-VID: d00c6ab4-5c10-4909-a7b8-7f12a249b481

License:

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

History

Date received : 30 December 2015

Date revision received : 21 February 2016

Date accepted : 02 March 2016

Page count

Figures: 1, Tables: 5, Pages: 12, Words: 2943

Funding

Funded by: Åsa Zetterling

Funded by: Lina Saferiene

Custom metadata

source-schema-version-number 2.0

component-id cre228

cover-date November 2016

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.3.2.2 mode:remove_FC converted:05.03.2018

Keywords: alveolar bone loss,chronic periodontitis,humans,orthodontic tooth movement,periodontal pocket depth,periodontal treatment

Data availability:

Keywords: alveolar bone loss, chronic periodontitis, humans, orthodontic tooth movement, periodontal pocket depth, periodontal treatment

Orthodontic treatment in periodontitis‐susceptible subjects: a systematic literature review

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Most cited references 45

The pathogenesis of human periodontitis: an introduction.

Mapping the pathogenesis of periodontitis: a new look.

Some periodontal tissue reactions to orthodontic tooth movement in monkeys.

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