Orthodontic treatment simultaneous to or after periodontal cause-related treatment in periodontitis susceptible patients. Part I: Clinical outcome. A randomized clinical trial

J Clin Periodontol. 2018 Feb;45(2):213-224. doi: 10.1111/jcpe.12835. Epub 2017 Dec 11.

Abstract

Aim: To compare two treatment strategies regarding the effect of orthodontic treatment on periodontal status in patients with plaque-induced periodontitis.

Subjects and methods: This was a randomized clinical trial. Fifty periodontal patients were randomly assigned to the test or control groups according to periodontal treatment timing. All patients received supra- and subgingival debridement following baseline examination. Control group patients received cause-related periodontal treatment before the start of orthodontic treatment and which was performed simultaneous to orthodontic treatment for the test group patients.

Results: No difference between the test and control groups was found regarding change of clinical attachment level (CAL) after periodontal-orthodontic treatment. Fewer sites with initial pocket depth (PD) of 4-6 mm healed after periodontal-orthodontic treatment in the test group (20.5%, IQR = 11.9%) in comparison with controls (30.4%, IQR = 27.1%) (p = .03). Anterior teeth [OR 2.5] and teeth in male patients [OR 1.6] had a greater chance for PD improvement ≥2 mm. Total periodontal-orthodontic treatment duration was significantly longer for the control group (p < .01).

Conclusions: Both groups showed a gain of CAL and a reduction in sites with PD ≥ 4 mm. Orthodontic treatment, simultaneously to the periodontal treatment, could be used in the routine treatment of patients with plaque-induced periodontitis.

Keywords: clinical attachment level; gingival recession; orthodontic treatment; periodontal treatment; periodontitis; pocket depth.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Malocclusion / complications*
  • Malocclusion / therapy
  • Middle Aged
  • Orthodontic Appliances, Fixed
  • Orthodontics, Corrective* / methods
  • Periodontal Attachment Loss / complications
  • Periodontal Attachment Loss / therapy
  • Periodontal Debridement / methods
  • Periodontitis / complications*
  • Periodontitis / therapy
  • Tooth Movement Techniques* / methods