Pre-orthodontic periodontal treatment: An undeniable necessity

Abstract

Introduction: Orthodontics and periodontics are two closely related disciplines, as they both affect the periodontium. An upstream analysis can reduce the risk of periodontal pathologies appearing or worsening. The aim of our study was to determine the risks of orthodontic forces on pathological periodontium. Methodology: This is a systematic review of articles evaluating the need for pre-orthodontic periodontal treatment using the PRISMA method. A total of 11 recent articles were selected. The study was carried out from January to March 2023. Results: The articles asserted a high risk of aggravation of pre-existing periodontal pathologies (54.5%). The 27.2% mentioned risks of gingivopathy, periodontitis, plaque accumulation, increased inflammation and loss of attachment. Nine percent of articles predicted a risk of increased bone dehiscence, gingival recession, alveolysis and root resorption. Discussion: Orthodontic therapy can be considered a risk factor for the periodontium through two phenomena: difficulty in meticulous hygiene practice; and osteoclasia caused by the infectious agents responsible for periodontal disease. One study showed that orthodontic treatment can transform gingivitis into periodontitis and/or aggravate pre-existing periodontitis. Conclusion: Periodontal treatment is essential before orthodontic treatment to optimize periodontal support and improve orthodontic therapy.