The effects of orthodontic treatment on periodontal tissues in patients with reduced periodontal support

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Abstract
The effects of orthodontic treatment on periodontal tissues in patients with severely reduced periodontal support were studied. A prerequisite for tooth movement was a reduction of periodontal inflammation by regular scaling and a high standard of oral hygiene. Surgical elimination of deepened periodontal pockets was not performed before orthodontic tooth movement. 20 patients took part in the study. The reduction of maxillary overjet was performed with light forces by elastics from removable orthodontic appliances. Oral hygiene, gingival inflammation, pocket depth and the alveolar bone level were recorded before hygiene treatment and before and after orthodontic treatment. As a result of the hygiene treatment, the Plaque Index and Gingival Index scores were markedly reduced. The values for pocket depth showed no major change. When comparing mean values for proximal bone level measurements before and after orthodontic tooth movement no difference could be seen. The individual proximal bone level values remained unchanged for every second surface. The maximum deterioration in bone level, measured as a percentage of tooth length, during orthodontic treatment was 10% in 9 surfaces out of 142. Provided careful preorthodontic hygiene treatment of the existing advanced periodontal disease is given and the forces are kept within physiological limits, the results from this clinical study show that no increased progression of marginal periodontitis will occur due to orthodontic tooth movement.

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